Underground Conduit Inspection Form
Please complete all relevant sections to document the inspection of the underground conduit.
Site Name/Location
*
Inspector Full Name
*
First Name
Last Name
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Conduit Identification/Number
*
Conduit Location (e.g., trench section, coordinates)
Conduit Type/Material
*
Please Select
PVC
HDPE
Steel
Concrete
Other
Installation Details
Inspection Method/Equipment Used
*
Visual Inspection
CCTV Camera
Mandrel Test
Rodding
Other
Visual Condition Assessment
*
Good
Minor Issues
Significant Defects
Defects or Observations
Measurements (e.g., diameter, length, depth)
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Upload a File
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of
Safety Notes
Corrective Actions Taken or Recommended
Final Inspection Outcome
*
Pass
Fail
Further Action Required
Submit Inspection Report
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