Completion Evidence Report - CC External - Region 4 - duplicate

• Site conducted

  Select

• Engineer Name

• Conducted on

  Date
• Location
  Address

• Customer Number

• Works Completed?

  Yes

  No

Permits

• Has the permit to dig & POWRA been completed for works?

  Yes

  No

• Is the excavation in public under a permit or in private?

  Public under a permit

  Private works

• Has the permit been started and closed?

  Yes

  No

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• Surface type (Select all that apply)

  Select C/W F/W Tarmac Concrete Pavers Slabs Soft

  • C/W
  • F/W
  • Tarmac
  • Concrete
  • Pavers
  • Slabs
  • Soft

• Measurements of dig

• Light test reading at MST completed (Include pictures)

  Yes

  No

• Light test reading completed on Cable (Include pictures)

  Yes

  No

• Length of cable pulled (Include pictures)

  Select 50 100 150 200 250 300 350

  • 50
  • 100
  • 150
  • 200
  • 250
  • 300
  • 350

• Duration of works (HH:MM)

• Any additional information?