Scoping
Name
First Name Last Name
Date
Month Day Year
Date Hour Minutes
Asset / Int. Number*
Manhole Reference Number*
Map Number
Project*
Street Name
Key Manhole (is this manhole key to future operations?)*
Yes No
Upstream or downstream*
US DS
Manhole Gen Location
Location Details
CCTV can sit over manhole Sewer requires cleaning Tidal/River conditions Potential ingress from other water sources Bridges / Embankments / Culverts / other structures High risk work areas Overhead Lines Old / Existing petrol stations Adjacent landfill sites NOISE sensitive area Scaffolding / Building / construction / demolition works Existing damage to land / property Schools / playgrounds National Trust land / property Network Rail nearby Canal/waterways nearby Motorways/major transport routes nearby Major infrastructure (Hospitals/airports/Police stations etc) nearby
Additional Location Details
Traffic Management
Chapter 8 Give & Take Stop / go 2 Way T/L 3 Way T/L 4 Way T/L Lane Closure Contraflow Road Closure TTRO Parked cars
Traffic Management Details
Additional TM Details
Major Traffic Route Recognised high / wide / heavy vehicle route One -way systems Narrow Roads Existing traffic control measures Railway / level / pedestrian / school crossing Short duration large crowd situations Steep gradients Traffic speed Restricted visibility Existing greenways Parking restrictions Weekend / OOH working requried
Asset information
Road Width
m
Cover
Width x Breadth
Shaft Depth
mm
Shaft Width-x-Breadth
Overall depth
m
Condition of Cover
Amount of Jetting Required
Amount of silt/debris
Type of survey
(Normal, Sonar, Flow through)
Flow in pipe
%
Flow speed
Work shift required
Comments from scoping camera
Survey Comments
Survey can be conducted TM required TTRO required (Parking restrictions) Jetting required MH cleaning required Protruding connections Can park over MH Civils required Private land Over-pumping required
Manhole State
Pipe Diameter
If Other
Pipe Material
If Other
System Type
If Other
Manhole comments
Re-line / Patching - Can Manhole be accessed*
Yes No
General information for asset connected to this manhole (entire length of asset)*
Network Rail Canals / Waterways Motorways / Major roads Minor roads Water treatment works Schools Housing areas Shopping centres Parklands Farmlands Wood lands Steep lands
Additional asset information
Contact Details (provide details for works on private land)
Contact Name
Contact Number / email
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Aegion is the parent company of Aegion Coating Services, AllSafe Services, The Bayou Companies, Brinderson, Corrpro Companies, Fibrwrap Construction Services, Fyfe Co., Insituform Technologies, MTC, Schultz, Underground Solutions and United Pipeline Systems
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Scoping