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

• As part of completing this feasibility, do not undertake any work on a Chorus pole / network.

• SafetyCulture form reference [Do not change]

• Chorus order reference [Do not change]

• Company you're working on behalf of

• Date of inspection

  Date

• If the order is approved, you understand that anybody carrying out any work on these poles has to be inducted to work in the Chorus network

Add pole

• Pole location
  Address

• Chorus pole tag number

• Upload a photo of the entire pole

  Media

• Upload a photo of the Chorus pole ID tag

  Media

• Upload as many photos as possible of the pole that shows all existing attachments

  Media

• You can add information about multiple attachments and components here.

Add attachment

• Attachment type

  Select CCTV IOT sensor Road sign Street lamp Solar panel Traffic mirror Other (add a note to specify)

  • CCTV
  • IOT sensor
  • Road sign
  • Street lamp
  • Solar panel
  • Traffic mirror
  • Other (add a note to specify)

• Equipment classification

  Classification 1

  Classification 2

  Classification 3

  Classification 4

• Describe how the equipment will be mounted

• Attachment height (cm)

• Attachment weight (kg)

• Make and model of attachment (if known)

• Attachment height from ground level to the bottom of the attachment (m)

Add component

• Attachment component 1

  Select Aerial Attachment ID / tag CCTV Power box Radio antenna Road sign Sensor Street lamp Solar panel Traffic mirror Warning sign Wireless antenna Other (add a note)

  • Aerial
  • Attachment ID / tag
  • CCTV
  • Power box
  • Radio antenna
  • Road sign
  • Sensor
  • Street lamp
  • Solar panel
  • Traffic mirror
  • Warning sign
  • Wireless antenna
  • Other (add a note)

• Component weight (kg)

• Upload a photo of where the equipment is intended to be attached, with all components (include annotations / sketches)

  Media

• That's all you need to do! You can press submit when you're ready.