Information
-
Service Order Number
-
Conducted on
Pole Information
-
Pole Asset Number
-
Asset Number Photo
-
Photo of full pole
-
Pole Address
-
Pole Tagged 'Do Not Climb'
- Red Tag
- Yellow Tag
- Blue Tag
- No Tag
-
Visual Inspection
-
Hammer & Probe Test
-
Any Issues with Pole head?
-
Distance between lowest power and NGA
- 100mm
- 200mm
- 300mm
- 400mm
- 500mm
- 600mm
- 700mm
- 800mm
- 900mm
- 1m+
-
Confirm distance here (eg: 600mm)
Tech Information
-
Issuer Name
-
Sign Here
-
Issuer Company
-
Parent Company
Tech Health & Safety
-
Which WTC's do you hold
- WTC 1
- WTC 2
- WTC 3
- WTC 4
- WTC 5
- WTC 6
-
What is your PPE rating?
-
What is the Minimum Distance between NGA and power?
- 100mm
- 200mm
- 300mm
- 400mm
- 500mm
- 600mm