Information

  • Document No.

  • Audit Title

  • Park Name

  • Conducted on

  • Inspectors name

  • Inspectors signature

  • Location
  • Company Name

  • Pole image

Pole angle

Pole angle - Pole excessively leaning - leaning to such an extent so as to have or cause secondary consequences that compromise safety or performance.

  • Low risk area

  • Plant attached to pole

  • Pole leaning no more then 20 deg

  • Pole leaning no more then 30 deg

  • High risk area

  • Plant attached to pole

  • Pole leaning no more then 15 deg

  • Pole leaning no more then 20 deg

  • Are there any secondary consequences of pole lean

  • Mains are excessively slack and evidence of conductor clashing can be seen

  • Inadequate ground clearance

  • A leaning pole and / or road with camber can contribute to motor vehicles clipping and damaging poles.

  • Leaning pole is caused by significant ground erosion.

Decay

Fungal Decay

  • Evidence of fruiting bodies or other evidence of head rot

  • Evidence of fruiting bodies approx one metre above the ground, usually associated with internal brown rot.

  • White flat growth, on the pole surface

  • Shaggy external appearance, may also indicate the presence of white rot - refer to inspectors manual for photographic examples.

  • Fungal decay evident in X arms

  • Pole head cap is in place

Termite infestation

  • Cracks in pole filled with mud - indicates termite activity

  • Any earth mud mounds on pole exterior

  • Mud tracks on pole exterior

  • Termite activity around bumps or branch stubs

Splitting, cracking or warping

  • Knot holes associated with cracks allowing the ingress of water

  • Pole exhibits major cracks to 50% of its length

  • Splits that may impact the integrity of the pole

  • Vehicle impact damage is evident that may reduce the pole integrity

Summary rating

  • Summary of pole condition - 1 = immediate action required to repair pole - 2 = further investigation required (core drill and inspect) - 3 = currently safe maintain and review in 2 years - 4 = currently safe audit in 5 years - 5 = new pole audit in 5 years as a low priority

  • Send electronic audit to BCC representative immediately

  • Detail major area of concern

  • Photo of follow up action required

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.