Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel/ crew size

  • Weather Conditions

  • Site Sign

  • Visitors

  • Eye/Face protection - Safety Glasses, faceshield

  • Hard Hats

  • High Vis

  • Safe access, not above 6' without fall protection

  • Proper footwear

  • Cords in good shape, GFCI used?

  • CHA completed and reviewed by all?

  • Equipment inspected? Daily? Monthly? Annual?

Underground

  • Miss Dig Contacted? add photos of site markings

  • Conduit Depth and Photos, Quantity installed

  • Isometric sketch of conduit runs to show length, elbows and fittings

  • Photos of conduit trenches showing depth - TR001

  • Photos of overview of conduit runs - TR002

  • Backfill with warning tape and compaction

  • Ground Ring - Depth, Photos, number of welds, qty. of wire and welds

  • Several photos of ground ring showing depth - GI007

  • sketch of overview with amount of whips and length of wire

  • Welds

  • Ground Thawing

  • Final Grading

Site Acces

  • Snow, Brush, Road

  • Fence

  • Photos of access Road - AT011

  • Photos of Compound - AT005

  • Photos of Driveway gate - AT010

  • Photos of new H-frame - AT007

  • Photos of E-911 address - AT012

  • Photos of all site signage - AT006

  • Photos showing Site Cleanliness - CO001

  • Photos of Electrical H-frames - CO003

  • Photos of telco H-frame - CO002

  • photos of Tower - CO004

Platform

  • Pavers

  • Feet

  • Frame

  • Grating

  • Grounding

Cabinets

  • Power Plant

  • Rectifiers/Converters running

  • Conduits Qty.

  • Telcoflex, length of sections, qty. of wire, terminations, marking

  • Grounding

  • Batteries

  • Existing BTS

  • Move, Rodent Protection, Grounded, secured, running

  • UMTS

  • Heater, GFCI, DC Power terminations, secured, solar shields, materials used

  • Diplexer cabinet

  • Backer board, grounding, conduit, secured

Electrical Service

  • Power Panel

  • Main Feed

  • Service

  • Meter Socket and disconnect, conduits, wire

  • Power Company, permits

Ice Bridge

  • Existing, remove, modify, move

  • Poles, concrete, caps

  • Horseheads, bridge, connections, grounding, cold galvanizing,

  • photos of Pole to ground ring - GI006

  • Photos of Pipe top Ice bridge grounding - GI005

  • Photos of Flex caulked - GI008

  • Photos of Bridge to Bridge grounding - GI004

  • Photos of full length view of ice bridge - GI003

Misc.

  • H frames

  • Demo

  • More

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.