16-001014-02A (Ultimate SCMMP)

As-constructed survey complete for
top of bunds and liner
Laboratory tests results of liner
material submitted and adequate
Delivery docket of liner material
supplied
Liner material installed and sealed
as per specification
Geotechnical engineer certification
of in-situ compaction or liner
placement
Geotechnical engineer certification
of key bunds

HOLD POINT: Superintendent or wetland designer inspection and sign-off before proceeding.

Comments (attach and refer to additional pages if necessary)




NB: As-constructed survey or drawings and photos attached.


Signed by superintendent:
Print name:
Date:
AND
Signed by wetland designer:
Print name:
Date:

FORM C — Hydraulic and Functional Structures
Purpose: To ensure that the hydraulic structures associated with the wetland are constructed in accordance with design
and specifications.

Items                                           Checked       Satisfactory       Action (if unsatisfactory)                               Initial

As-constructed survey completed
and attached to this form

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                  CONSTRUCTION AND ESTABLISHMENT SIGN-OFF FORMS – CONSTRUCTED WETLANDS
                                                     Version 1, February 2009© South East Queensland Healthy Waterways Partnership 2010
©South East Queensland Healthy Waterways Partnership 2009