FTTH - City Fibre - Install on Demand - Pre Survey

• Site

• Postcode:

• MA Details:

• Job Number Reference

• City Fibre Release ID

• Routing (PN/SN Number)

• Surveyed by:

• Date of Survey:

  Date

• MA Contact Details:

• Photograph of Notice Board

  Media

• Photograph of Open SN cab

  Media

• Photograph of Closed SN cab

  Media

Site Information

• Number of Dwellings

• Number of Floors

• Photo of building / block

  Media

Access Requirements

• Key Type

  G Key

  F Key

  Other

• Provide details

• Access to gardens

  Yes

  No

  N/A

• Dwelling number and contact details if available

System Information

• How will the MDU be fed?

  PIA

  ASN

  Network Toby

• Civils required?

  Yes

  No

• Provide description of what civils are required (meterage, ground type etc)

• Photos of proposed civils route

  Media

• Proposed Installation

  Internal

  External

• Has any asbestos been identified or suspected on site?

  Yes

  No

• Provide photo

  Media

• Does proposed route avoid areas of concern?

  Yes

  No

• Are asbestos scrapes required

  Yes

  No

• Is building classed as High Risk Building? (7 storeys or 18m)

  Yes

  No

• Please provide photos of DP location (minimum of 3 photos from various locations)

  Media

• Please provide photos of proposed cable route

  Media

• Please provide photos of any areas of concern

  Media

• Please provide information of any areas of concern

• Please provide details of what stock (Please include quantity, lengths, type etc)

Sign Off

• Additional Notes / Information

• Name

  Sign

• Completed Survey

  Date