Title Page
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Conducted on
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Prepared by
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Location
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Site Name
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Site Contact
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Scope of works required
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Date / Time
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Surveyor Name
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Will the site allow Elecomm to use their access equipment?
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Who will issue work permit upon arrival?
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Does the site contact want the works completing out of hours? Is there any restrictions in the working area?
Survey Details
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Photo of cabinet 1 - Full length - must be clear to see all patch panels, IP Adresses, switches & PDU's
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Height of cabinet from floor
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Location and name of cabinet
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Size of cabinet 12u, 42u etc and depth 500mm, 600mm etc
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Photo of cabinet 2 - Full length - must be clear to see all patch panels, switches, IP Adresses & PDU's
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Height of cabinet from floor
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Location & Name of cabinet
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Size of cabinet 12u, 42u etc and depth 500mm, 600mm etc
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Photo of additional cabinet
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Photo of additional cabinet
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Identify fibre type (OM1, OM2, OM3) and connection type (LC, SC, ST etc) If more than 1 list all
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Will access equipment be required to allow installation?
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Size & type of access equipment required
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Length of cable run
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Will any additional containment be required? If so list type and length here.
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Estimate how long the job will take. if more than 2 men are required note this.
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List all required materials to complete
Electrical information
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Location of Distribution board
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Photo of Distribution board
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Close up photo of existing MCB's
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Number of spare ways
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Containment type and capacity from DB to installation position
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Length of rum from DB to installation location
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Any access limitations?
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Photo of existing electrical installation certificate - First 3 pages minimum
Supporting Photos
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Photo of cable run 1
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Photo of cable run 2
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Photo of cable run 3
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Photo of AP location 1
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Photo of AP location 2
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Photo of AP location 3
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Photo of any drawing supplied with notes
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Any other relevant photos to support survey
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Any other relevant photos to support survey
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Any other relevant photos to support survey
Sign Off
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Name of client
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Client Sign off
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Engineer sign off
