Title Page
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Site
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Conducted on
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Contract number
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Is access to site available?
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Engineers signature
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Staff position
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Staff signature
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The staff signature time stamp is the deemed to be the off site time.
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Is access to the ATM Locations available?
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Engineers signature
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Staff position
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Staff signature
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The staff signature time stamp is the deemed to be the off site time.
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Time on site.
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Please record the name of the ALS Representative who was informed of your arrival.
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I confirm that I have inspected my step ladders prior to starting work.
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Please provide a photograph of you step ladder tag
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Please select the type of installation
- Replacement
- New
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Are there any additional devices to reconnect?
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Please select the additional devices
- Door contact
- Camera
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Number of ATM's?
- 1
- 2
- 3
- 4
- 5
- 6
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U@ Number for ATM 1
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LFS type for ATM 1
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Zone Number for ATM 1
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Post installation photograph of ATM 1
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U@ Number for ATM 1
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LFS type for ATM 1
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Zone Number for ATM 1
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Post installation photograph of ATM 1
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U@ Number for ATM 2
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LFS type for ATM 2
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Zone Number for ATM 2
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Post installation photograph of ATM 2
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U@ Number for ATM 1
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LFS type for ATM 1
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Zone Number for ATM 1
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Post installation photograph of ATM 1
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U@ Number for ATM 2
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LFS type for ATM 2
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Zone Number for ATM 2
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Post installation photograph of ATM 2
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U@ Number for ATM 3
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LFS type for ATM 3
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Zone Number for ATM 3
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Post installation photograph of ATM 3
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U@ Number for ATM 1
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LFS type for ATM 1
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Zone Number for ATM 1
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Post installation photograph of ATM 1
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U@ Number for ATM 2
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LFS type for ATM 2
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Zone Number for ATM 2
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Post installation photograph of ATM 2
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U@ Number for ATM 3
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LFS type for ATM 3
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Zone Number for ATM 3
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Post installation photograph of ATM 3
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U@ Number for ATM 4
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LFS type for ATM 4
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Zone Number for ATM 4
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Post installation photograph of ATM 4
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U@ Number for ATM 1
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LFS type for ATM 1
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Zone Number for ATM 1
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Post installation photograph of ATM 1
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U@ Number for ATM 2
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LFS type for ATM 2
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Zone Number for ATM 2
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Post installation photograph of ATM 2
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U@ Number for ATM 3
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LFS type for ATM 3
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Zone Number for ATM 3
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Post installation photograph of ATM 3
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U@ Number for ATM 4
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LFS type for ATM 4
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Zone Number for ATM 4
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Post installation photograph of ATM 4
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U@ Number for ATM 5
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LFS type for ATM 5
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Zone Number for ATM 5
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Post installation photograph of ATM 5
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U@ Number for ATM 1
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LFS type for ATM 1
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Zone Number for ATM 1
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Post installation photograph of ATM 1
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U@ Number for ATM 2
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LFS type for ATM 2
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Zone Number for ATM 2
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Post installation photograph of ATM 2
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U@ Number for ATM 3
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LFS type for ATM 3
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Zone Number for ATM 3
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Post installation photograph of ATM 3
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U@ Number for ATM 4
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LFS type for ATM 4
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Zone Number for ATM 4
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Post installation photograph of ATM 4
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U@ Number for ATM 5
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LFS type for ATM 5
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Zone Number for ATM 5
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Post installation photograph of ATM 5
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U@ Number for ATM 6
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LFS type for ATM 6
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Zone Number for ATM 6
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Post installation photograph of ATM 6
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Has the system been demonstrated to the customer?
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All equipment functioning correctly?
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Time on site
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Engineers signature
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Staff position
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Staff signature
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The staff signature time stamp is the deemed to be the off site time.
