Title Page
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Conducted on
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Prepared by
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Location
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Line
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Station Name
- Waikanae
- Paraparaumu
- Paekakariki
- Pukerua Bay
- Plimmerton
- Mana
- Paremata
- Porirua
- Kenepuru
- Tawa
- Redwood
- Linden
- Takapu Road
- Wellington Platform 10
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Coupler Box Platform
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Code on Front of Coupler Box
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Station Where Installed
- Waikanae
- Paraparaumu
- Paekakariki
- Pukerua Bay
- Plimmerton
- Mana
- Paremata
- Porirua
- Kenepuru
- Tawa
- Redwood
- Linden
- Takapu Road
- Wellington Platform 10
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GPS Location of Coupler Box
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Coupler Box Exterior condition
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Coupler Box Lock Mechanism, does it operated correctly?
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Coupler Box Door, what is the conditions of the hinges?
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Overall Condition Rating of BOX
- 1 - Good Condition
- 2 - Minor Defects Only
- 3 - Average Condition requires general Maintenance
- 4 - Poor Condition Immediate attention Required
- 5 - Very Poor Box unserviceable
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Interior Condition of Box
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Is the coupler adapter present?
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Is the Trolley Present?
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Is the Trolley in good Condition and does it Operate Correctly?
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Are the 2 hoses present and in Good Condition?
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Take Photos of the box, lock, hinges and contents inside.
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Add any comments applicable to this box and location.
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Signature of Auditor
