Anonymous

[JE] Build assessment for attachments to Chorus poles - duplicate

Fill out this form if you have attached a piece of equipment to a Chorus pole.

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Title Page

Thanks for filling out this form. It shouldn't take you too long. Only fill out this form when you have completed the build for the attachment.
Order form reference
Chorus order reference

Pole

Add pole

Pole location
Chorus pole tag number

Build information

Date of installation
Name of person installing equipment
Have all of the attachments and components been installed onto the pole as described in the order?
Upload a photo of the entire pole with all attachments and components visible
Upload a close up photo of the attachment / components on the pole
Upload a close up photo of the brackets and bolts
Maintenance plan review date
I confirm I have built all attachments and components to the pole as per the standards set out by Chorus

Anonymous

[JE] Build assessment for attachments to Chorus poles - duplicate

Fill out this form if you have attached a piece of equipment to a Chorus pole.

Use this Template

Print as PDF

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.