CFH PIA Blockages

• Site conducted

  Select

• S Reference

• Fibre ID

• PIA Number (PIANOI Ref)

• Duct Section Reference Number

• PN Reference

• Conducted on

  Date

• Prepared by

• Location
  Address

• House Number and Post Code

Pre Works

• Please provide an image/screenshot of the A55

  Media

• Is the A55 correct?

  Yes

  No
Work In Progress (click here to add)

• Please confirm dig coordinates (ie 1.2m x 400mm x 600mm)

• Please provide a photo of the pre work dig area.

  Media

• Please provide a photo of the full site set up. To include Barriers, Signage, Permit Boards etc..

  Media

• Buried Services Noted to Dig.

  None

  Electricity

  Gas

  Water

  Other (describe in notes)

• Please provide a photo of the location of buried services.

  Media

• Please provide a photo of the open excavation / damage to ducting.

  Media

Repair and Reinstatement

• Please provide photo evidence of repair to ducting (showing both collar ends and cable straps).

  Media

• Please provide photo evidence of reinstatement of wearing course.

  Media

Closing Dimensions

• Please confirm closing dimensions.

Site Shutdown

• Please provide a photo of the shut down site (all tools and rubbish removed)

  Media

Duct Checklist

• Was a grey duct repair kit used?

  Yes

  No

• Were cable straps used on the repairs?

  Yes

  No

• Core drilled and pointed

  Yes

  No

• Is duct >150mm above the chamber floor?

  Yes

  No

• Is duct >75mm from the adjacent wall?

  Yes

  No

• Is duct >50mm from other ducts?

  Yes

  No

• Is ducting cut flush to brickwork?

  Yes

  No

• Is draw rope installed?

  Yes

  No

• Please provide a photo of A end chamber showing duct in use.

  Yes

  No

  N/A

• Please provide a photo of B end chamber showing duct in use.

  Yes

  No

  N/A

• Job Status

  Select Blockage Complete - Fully Reinstated De-Silt Complete De-Silt Incomplete New Track Complete - Fully Reinstated Blockage Incomplete - Revisit required for reinstatement (specify in notes and add images) New Track Incomplete - Revisit required for reinstatement (specify in notes and add images) Job Failed - Further Investigation Required (specify in notes and add images)

  • Blockage Complete - Fully Reinstated
  • De-Silt Complete
  • De-Silt Incomplete
  • New Track Complete - Fully Reinstated
  • Blockage Incomplete - Revisit required for reinstatement (specify in notes and add images)
  • New Track Incomplete - Revisit required for reinstatement (specify in notes and add images)
  • Job Failed - Further Investigation Required (specify in notes and add images)

• Total time spent on the job (in hours)

• Auditor Sign Off

  Sign