Clearvision - Underground Service Locating Assessment Version 2

• Employee Name:

• Employee Name:

• Employee Branch/Office Location:

• Employee Position:

• Location
  Address

• Site: Address:

• Conducted on

  Date

• Prepared by

• Service Plans: Can read and understand service plans provided?

  Yes

  No

• Marking Out: Understands the correct Marker paint for each underground service?

  Yes

  No

• Observation: Understands how to identify services that may not be on Underground Service plans i.e. Electric gates, sprinklers, Telco Networks?

  Yes

  No

• Equipment: Is confident and familiar with the utilisation of the "Cat 4 Locator" and its functions?

  Yes

  No

• General Maintenance: Demonstrates correct storage, handling, cleaning and Pre-Start procedures including battery Check before use?

  Yes

  No

• Operation: Transmitter (Induction Clamp) - Correct connection and placement of clamp?

  Yes

  No

• Operation: Transmitter (Direct Connection) - Correct connection and placement of Genny (Transmitter) and Earth?

  Yes

  No

• Operation: Transmitter (Broadcast Induction) - Correct connection and placement of Genny (Transmitter)?

  Yes

  No

• Operation: Receiver - Understands different Modes and Frequency Strength?

  Yes

  No
Assessed By:

• Signature:

  Sign

• Date:

  Date

Health & Safety JSA/Team Brief (Tailgate)

• JSA/Take 5/Sitetrax Filled out Correctly

  Pass

  Fail

  N/A

• Notes

• SWMS or equivelant are up-to-date

  Pass

  Fail

  N/A

• Notes:

• All Hazards identified and Recorded

  Pass

  Fail

  N/A

• Notes:

• Hazard Controls Methods recorded & implemented

  Pass

  Fail

  N/A

• Notes:

• Work Pack Studied and explained to team

  Pass

  Fail

  N/A

• Notes:

• Tasks Allocated to Team members

  Pass

  Fail

  N/A

• Notes:

• All persons working onsite have been inducted and signed in

  Pass

  Fail

  N/A

• Notes:

• All Environmental Controls implemented

  Pass

  Fail

  N/A

• Notes:

Site Setup Traffic Management

• Traffic Management plan implemented

  Pass

  Fail

  N/A

• Notes:

• Adequate signs and cones setup

  Pass

  Fail

  N/A

• Notes:

• Workzone and safe zone correctly established

  Pass

  Fail

  N/A

• Notes:

• Pedestrian access, correctly managed

  Pass

  Fail

  N/A

• Notes:

Site Setup Prestart Check/Site Management

• All PPE onsite/person and checked for wear & tear

  Pass

  Fail

  N/A

• Notes:

• Equipment/Tools are and checked for wear & tear

  Pass

  Fail

  N/A

• Notes:

• Worksite is tidy

  Pass

  Fail

  N/A

• Notes:

• Vehicles are parked correctly

  Pass

  Fail

  N/A

• Notes:

Task - Cable Identification

• All Service Plans available are onsite

  Pass

  Fail

  N/A

• Notes:

• Cable locator is calibrated

  Pass

  Fail

  N/A

• Notes:

• Identify correct location method for service types

  Pass

  Fail

  N/A

• Notes:

• Can identify different trace signals from false signals

  Pass

  Fail

  N/A

• Notes:

• Can disable strike alert

  Pass

  Fail

  N/A

• Notes:

• Understands colours of cable markouts

  Pass

  Fail

  N/A

• Notes:

• Identfy existing markouts e.g. symbols, depth, etc

  Pass

  Fail

  N/A

• Notes:

• Locate identification method e.g. Passive or Direct

  Pass

  Fail

  N/A

• Notes:

• Cable route is identified and marked

  Pass

  Fail

  N/A

• Notes:

• Pilot hole on service to confirm markout

  Pass

  Fail

  N/A

• Notes:

Technician Competency

• Assessment results: Is the Technician competent in all areas?

  Yes

  No

• Further Training Requirements:

• Date by which Employee is to be reassessed?

  Date

• ***REASSESSMENT TO BE COMPLETED ON A NEW FORM***

• Assessment conducted by:

  Sign

• Acknowledged by Employee:

  Sign

• Select date

  Date

• I Give consent for authorised Clearvision Communications personnel to uplift my record of learning from any training provider for the purpose for which
  it is intended, i.e. to confirm and validate my skills and competencies.

• Employee Full Name:

  Sign

AUTHORISATION to be completed for successful Assessments

• I certify that the above, named employee has located at,

• [Print Address]

• Meets the necessary requirements to carry out the work associated with the work type competency the has been assess on, as detailed above

• Name of person certifying Competency:

  Sign

• Position:

• Competency Re-validation date: (Valid for 2 years from this date)

  Date