16-001014-02A (Ultimate SCMMP)

Photos taken and attached to this
form
Inlet pipe and headwall at correct
locations and levels (+ 25 mm)
Inlet zone connection pit or pipe
correction size, location and level (+
25 mm)
Outlet riser connection, location, size
and levels or risers correct (+ 25 mm)
Outlet pipe and headwall at
correction locations and level (+ 25
mm)
Bypass weir correct width and level
(+ 25 mm)
Maintenance pipe and valve installed
at correct location and level
Maintenance access installed to inlet
zone
Rock or concrete base constructed to
inlet zone
Rock protection provided at correct
locations and rock size consistent
with design
Seepage collars installed to all pipe
outlets from wetland
HOLD POINT: Superintendent AND Wetland Designer inspection and review of test results and certifications
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 D — Topsoil and Finished Levels
Purpose: To ensure the topsoil is installed to the correct depth and finished levels of wetland are correct and meet the
design.

Items                                          Checked        Satisfactory       Action (if unsatisfactory)                               Initial

Topsoil meets the requirements of
AS4419 and laboratory tests
provided



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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