Information

  • Document No.

  • Filled out on

  • Employee Name

  • Originated by

  • Date

  • Location

  • Meter Number

  • Work Required

  • Material Used

Pole

  • Pole Length

  • Secondary Insulator

  • K14

  • How many?

  • House knob

  • How many?

  • Neutral Insulator

  • J10

  • How many?

  • Offset bracket

  • How many?

  • Upset bolt

  • How many?

  • Primary Insulator

  • Polymer

  • How many?

  • Porcelain

  • How many?

  • Arm pin

  • How many?

  • Saddle pin

  • How many?

  • Pole top pin

  • How many?

  • Transmission Insulator

  • Polymer

  • Side Stack

  • How many?

  • Top Stack

  • How many?

  • Suspension

  • How many?

  • Porcelain

  • Side Stack

  • How many?

  • Top Stack

  • How many?

  • Suspension

  • How many?

Cross Arm

  • 8ft arm

  • How many?

  • 10ft arm

  • How many?

  • Hughes arm

  • How many?

  • Braces

  • Regular Braces

  • Heavy Braces

  • 5/8" bolts

  • Machine

  • How many?

  • DA

  • How many?

  • Eye

  • How many?

  • 3/4" bolts

  • Machine

  • How many?

  • DA

  • How many?

  • Eye

  • How many?

Hardware

  • Type

  • Other

  • 3/4"

  • How many?

  • 5/8"

  • How many?

  • 2" Flat

  • How many?

  • 3" Curve

  • How many?

  • 4" Curve

  • How many?

Misc

  • Other

  • Item
  • Item Description

  • How many

  • Worked by

  • Date

  • Signature

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.