Information

  • Technician Name

  • Photo of Lead

  • Company

  • Capability

  • Business Unit

  • Type of Assessment

  • Vehicle Make

  • Vehicle Model

  • Front photo of Vehicle

  • Conducted on

  • Prepared by

Scoping

  • Did technician complete a successful scope highlighting a like for like aerial install with agreed internal wiring path and ONT install location?

  • Did technician complete a successful scope where no existing / usable duct was available with agreed install wiring path and ONT install location?

Mandatory Tools and Equipment

  • Air Compressor - For fibre blowing (Must be Oil less)

  • 10m Air Compressor Rubber pipe/tube<br>

  • Power Generator/Invertor <br>Mandatory unless Air Compressor above is Self Powered)

  • Heavy duty Power Extention Lead

  • Blowing Gun Chorus Approved

  • 100m Push Rod

  • Concrete Saw 10mm blade & Diposable Grout Bags for Reinstatement

  • Plastic water container - 20l

  • Cones - 900mm high with reflectors

  • Barriers - reflective

  • Pedestrian Signs

  • Grafting Spade

  • Trenching Shovel Long Handle

  • Rake Steel

  • Trench Tamper - Rammer

  • Brush - Broom

  • Manhole lifter - Combination lifter

  • Manhole lifter - Sika blue lift

  • Hammer Claw 20oz

  • Screw Driver set

  • Crimping tool UR/UY/UG - Scotch Locks

  • Culking Gun - (For Gel/Silicone seal)

  • Micro duct cutter (Festo)

  • Multi-duct ratchet cutter

  • Double sheath cutter (26-way duct cutter)

  • Micro-duct cutter - depth control (pressmaster)

  • Strapping Tool - Bandit Strap for steel strapping on poles

  • Tri Wing screwdriver

  • Punch down Tool - 110

  • Punch down Tool - Krone

  • CrimpingTool RJ45 / RJ12<br>

  • Copper Tone Source - Beep it Tone and Probe<br>

  • Fibre Sharps disposal can

  • Fibre connector cleaner

  • Fibre Inspection Probe (FIP Tester)

  • Power Meter JDSU (prefered)

  • Fibre Fusion Splicer

  • Fibre Optic stripper Chorus approved

  • Kevlar Scissor

  • P-touch label machine or similar

  • Drill Hand Held 18v preferable

  • Drill Bit - Auger 8mm wood

  • Drill Bit - Concrete / Masonary 8mm

  • Bosch Power detector PM10

  • Step ladder

  • 6 meter extention ladder

  • Harness suitable for pole work

  • Pole safety belt

  • First Aid kit

  • Hi-Vis Jacket (acceptable condition)

  • Fire retardant overall 8.5cal minimum

  • Hard Hat (acceptable condition)

  • Safety Glasses (acceptable condition)

  • Gloves Leather (acceptable condition)

  • Steel cap boots with laces (acceptable condition)

  • Chorus Branding on Vehicle

  • VisionStream Branding on Vehicle

  • SHEWMS Folder Present

Additional Tooling Required

  • Sledge Hammer 10LB - concrete breaking

  • Hack Saw

  • Utility Service locator

  • Measuring Wheel

  • Tent and Metal Tent frame

  • Pole Buckets - Canvas

Flash 9 Fibre Termination

  • Is ABFU routed to target SC tray listed on the service order?

  • Is the correct ABFU tube chosen and fitted correctly with a divisible seal?

  • Is 1.2m of ABFU managed onto tray from tray entry point on the left with 1m stripped back?

  • Is the correct splitter tail routed through from the SE tray to SC tray with entry point on the right hand side?

  • Are all stray/ dark fibres retained and managed back within the SE tray?

  • Are splitter and customer fibres managed neatly onto the SC tray with no macrobends visible?

  • Is the Technician able to identify the UMS?

  • Is the technician able to identify the Bridge?

  • Did the technician wear approved safety glasses at all times while working with fibre?

  • Photo evidence of final outcome/result

  • Comments:

Labelling

  • Is the customer address from the job card correctly included on the label?

  • Are the splitter details correctly detailed on the label?

  • Is the correct micro-duct number listed on the label?

  • Is the correct length of ABFU blown listed on the label

  • Photo evidence of final outcome/result

  • Comments:

Health & Safety walk through

  • Did technician complete a Take 5 correctly?

  • Did technician complete SHEWMS correctly?

  • Did technician demonstrate correct site safety in setting up work site with cones & barriers while maintaining minimum site safety distance?

Pole climbing Assessment

  • Did the technician demonstrate that he is able to carry out the basic pole test?

  • Is the technician wearing approved overalls with a fire rating of 8.0 cal or better?

  • Does the technician have the correct PPE including hard hat (with chin strap) and safety boots laced up above the ankles?

  • Is the technician wearing approved safety glasses at all times while climbing the pole?

  • 6 m extension ladder is compliant and fitted with approved header rope in good order and condition?

  • Can the technician demonstrate that he can wear a correct fitting approved harness with a pole strap that fits around the pole twice?

  • Did the technician demonstrate that he is able to tie off the base of the ladder correctly?

  • Can the technician provide the correct minimum approach distances (MAD) for working in the vicinity of both low and high voltage overhead power?

Boundary Joint

  • Do micro-duct ends have a clean cleave on each end?

  • Have continuity wires been correctly joined to allowed future locating through boundary joint?

  • Is the straight through connector fitted correctly and firmly to the ruggerdised single-way service lead?

  • Are the tubes installed correctly inside the straight through connector?

  • Is the fibre clearly visible in the centre of the straight through connector?

  • Are both ends of joint closure correctly zip-tied?

  • Did the technician wear approved safety glasses at all times while in the practical training area?

  • Photo evidence of final outcome/result

  • Comments:

Surface Mounting

  • Is entry and exit of surface moutned cabling on fence in HDPE 20m duct which meets the 120mm MBR for ruggedized single way?

  • Does the ruggedised single way meet or exceed the MBR of 120mm at all times?

  • Did the technician use approved P-clips and galvanised or stainless steel screws for use when fastening P-clips to wooden structures?

  • Does the spacing of the P-clips meet the maximum spacing standards for fixing on supported (600mm) and unsupported (300mm) surfaces?

  • Are the P-clips evenly spaced on the fence?

  • Is the ruggedised straight on the Fence? (not hanging off fence rail)

  • Has effort been made to find the least conspicuous location possible on the fence?

  • Did the technician wear approved safety glasses at all times while in the practical training area?

  • Photo evidence of final outcome/result

  • Comments:

Aerial Termination

  • Is the aerial fixed fibre installed with no macrobends visible?

  • Are screw eye and drop clamp (wedge clamp OR Q-clamp) installed correctly on premises?

  • Does Q-clamp have 2.5 turns of fixed fibre managed around the drum with correct entry and exit observed through the clamp?

  • Are external fittings CNSP approved UV stable black p-clips, or galvanised or stainless steel saddles?

  • Are installed P-clips evenly spaced on the wall?

  • Where cable is surface mounted is it straight/vertical on the wall?

  • Are surface mounted bends supported at the centre of the bend?

  • Did the technician wear approved safety glasses at all times while in the practical training area?

  • Photo evidence of final outcome/result

  • Comments:

Installing an FTP

  • Is the FTP installed between 300mm and 1500mm above ground level?

  • Was a power locator used to confirm location of mains power prior to positioning of the FTP?

  • Is the ruggedised single way installed in a white 20mm PVC or 16mm HDPE pipe to the FTP?

  • Is the starbust laser warning label fitted correctly on the front of the FTP - bottom centre

  • Are all outdoor fittings galvanised or stainless steel? (not zinc plated and no dissimilar metals)

  • Are the EPFU fibres managed correctly on the splice tray with no macrobends visible?

  • Has the technician managed 1.2m fibre onto the splicing tray in the FTP with 1m stripped?

  • Is the splice connection within the FTP made using 40mm heat shrink splice protector?

  • Are the ruggedised single-way brass coated steel, or aluminium continuity wires capped with red two-port connectors to avoid the sharp ends causing injury?

  • Is the divisible seal (Filo-foam) correctly installed on the 5mm tube?

  • Is the black outer sheath of the ruggedised duct protruding 20mm up from the inside of the FTP box?

  • Has copper been correctly integrated with the internal house wiring via white/white blue pair.

  • Are all the other copper pairs capped with red insulating scotch locks?

  • Did the technician wear approved safety glasses at all times while in the practical training area?

  • Photo evidence of FTP results/final outcome

  • Comments:

Installing an ONT

  • Is the ONT installed between 300mm and 1500mm above ground level?

  • Is the ONT installed level on the wall?

  • Has 1.2m EPFU fibre been managed onto the ONT fibre management tray with 1m stripped?

  • Has the technician managed fibre correctly with no macrobends visible?

  • Has the SC/A fibre pigtail been correctly fusion spliced to the EPFU fibre from FTP?

  • Has a 40mm heat shrink splice protector been used to protect the splice within the ONT fibre management tray?

  • Has the SC/A pigtail connector been inspected before being plugged directly into the ONT connector?

  • Did the technician wear approved safety glasses at all times while in the practical training area?

  • Photo evidence of final outcome/result

  • Comments:

Installing an ITP

  • Is the ITP mounted level and in keeping with location of the ONT?

  • Is the ITP labelled with its function? e.g. ITP/ Voice

  • Is the surface mounted hybrid cable installed neatly on the wall with evenly spaced clips spaced evenly and with bends in cable supported (clipped) in the middle of the bend?

  • Are there any macrobends (less than 60mm) visible in the surface mounted hybrid cable?

  • Is the white/blue-white pair terminated correctly and securely onto the RJ45 keystone? (blue in position 4 and white on position 5)

  • Can the technician identify the only correct tool (110 punch down tool) for terminating copper wires onto the keystone jack?

  • Was the black cap installed correctly on the keystone?

  • Are all four copper pairs routed correctly from the ONT fibre management tray to the ITP with no bare copper wires visible?

  • Are all the other pairs capped/insulated with red 2 port cap with enough length available to cater to any future requirements.

  • Has the technician installed the UTP patch cord between the POT's 1 port of the ONT and Port 1 of the ITP?

  • Photo evidence of final outcome/result

  • Comments:

Macrobends (Compulsory Section)

  • Are there any macrobends in any section of the technicians work? If Fail, technician has failed the practical assessment.

Reinstate Work Area exactly as it was before commencing. (Mandatory Section. Can be retrospectively Failed)

  • Was the area reinstated to its original condition at the end of the assessment?

Overall Summary

  • General Outcome of Assessments taken:

  • Tools Check:

  • Scoping:

  • Skills Assessments Overall:

  • Breakdown of Tasks:

  • Flash-9 Management:

  • Labelling:

  • H&S:

  • Pole climbing Assessment:

  • Final Skills Assessment Overall

  • No Macrobends:

  • Reinstate work area:

  • Overall Comments on outcome:

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.