Title Page
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Time & Date:
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Completed by:
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Build Town Ref:
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PDP:
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A55# :
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Which connect fibre #DP is affected? (find on work pack map)
Chamber 1
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Chamber 1 location:
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Chamber 1 description:
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Surface type:
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Photo(s) of chamber 1 set up: (including barriers)
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Rods used:
- 6mm
- 9mm
- 11mm
- 14mm
- 25mm
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Photo(s) of rods in bore (Geo-tagged and time-stamped) :
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Number of Bores:
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Number of cables currently in bore:
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Current capacity of bore:
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BT Duct Reference ( e.g. 1479 - R, found on work pack map):
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How far is the blockage from chamber 1? (in metres):
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Any additional comments?
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Any additional photos?
Blockage Details
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Please complete blockage details and provide location and photo evidence in the sections below. If there are multiple blockages in one location, please put them on this form. The button looks like this:
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Is TM Required?
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What TM Required (I.E. 2x way lights) :
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Can 2.5 metres be maintained for vehicles at all times?
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Is overlay required? (must be greater than 3m)
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If overlay is required you do not need to provide blockage information.
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If overlay is not required, please complete blockage information below.
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Photo of blockage: (please spray a X and CF on blockage)
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Location Details (please drop a pin on the blockage)
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Please take a photo of the house/property/defining features nearest the blockage: (helps us to find it, if the location pin is incorrect)
Chamber 2
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Location of chamber 2:
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Chamber 2 description:
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Surface type:
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Photo(s) of chamber 2 set up: (including barriers)
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Rods used:
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Photo(s) of rods in bore (Geo-tagged and time-stamped) :
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Number of bores:
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Number of cables currently in bore:
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Current capacity of bore:
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BT Duct Reference (e.g. 1479 - R):
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How far is the blockage from chamber 2? (in metres):
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Any additional comments:
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Any additional photos:
