Title Page

  • Connect fibre ident a.png
  • CF-SITE-AUDIT Version 1 Revision 1 Dated 05/07/2022

  • Conducted on

  • A55 raised by

  • Location
  • Build Town Ref

  • PDP

  • DP #

  • A55#

  • Chamber Type / Pole Reference

  • Contractor

  • Chamber 1 Description

  • Chamber 2 Description

  • Blockage Location:

  • No. of Blockages in a Section

  • Blockage Distance from Chamber 1 (m)

  • Blockage Distance from Chamber 2 (m)

  • Unidentified Distance in case of 2 Blockages in a section (Distance B/W 2 Blockages) (m)

  • Duct Reference:

  • X and Y

  • Duct Length (m)

  • Any TM Required?

  • Is the duct section on a red route or bus lane?

  • Is the duct section on a cycle lane?

  • Number of Bores:

  • Number of cables currently in bore:

  • Current capacity of bore:

  • Rods used:

  • Site Photo from approx 2m away:

  • Rod in Bore:

  • Site photo 2:

  • Rod in receiving bore:

  • "X" and "CF" sprayed to mark blockage:

  • "X" and "CF" sprayed to mark blockage No 2 if Exist:

  • Any additional photos:

  • Any additional comments

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.