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LMS1 EXISTING POLES revb
LMS1 EXISTING POLES revb
CB Energy

LMS1 EXISTING POLES revb

Pole upgrade record

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Free LMS1 EXISTING POLES revb Checklist

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Information

  • Document No.

  • Client / Site

  • Conducted on

  • Night /Day

    • Night
    • Day

  • Prepared by

  • Personnel present

  • Location

Item 1

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 2

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 3

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 4

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 5

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 6

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 7

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 8

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 9

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item10

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item11

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item12

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 13

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item14

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 15

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 16

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 17

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item18

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 19

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 20

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 21

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 22

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 23

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 24

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 25

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 26

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 28

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 29

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 30

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 31

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 32

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 33

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 34

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 35

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 36

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 37

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 38

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 39

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 40

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 41

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 42

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 43

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 44

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 45

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 46

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 47

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 48

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 49

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 50

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 51

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 52

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 53

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 54

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 55

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 56

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 57

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 58

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 59

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 60

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 61

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 62

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 63

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 64

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 65

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 66

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 67

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 68

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 69

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 70

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 71

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 72

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 73

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 74

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 75

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 76

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 77

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 78

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 79

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 80

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 81

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 82

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 83

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 84

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 85

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 86

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 87

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 88

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 89

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 90

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 91

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 92

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 93

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 93

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 94

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 95

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 96

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 97

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 98

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 99

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 100

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 101

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 102

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 103

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 104

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 105

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 106

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 107

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 108

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 109

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 110

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 111

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 112

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 113

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 114

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 115

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 116

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 117

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 118

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 119

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 120

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 121

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 122

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 123

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 124

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 125

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 126

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 127

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 128

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 129

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 130

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 131

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 132

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 133

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 134

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 135

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 136

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 137

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 138

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 139

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 140

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 141

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 142

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 143

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 144

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 145

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 146

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 147

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 148

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 149

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

Item 150

  • Station and location of plant being inspected

  • Photo of pole include pole number if possible and internal components as found

  • Are the luminaries functional at the time of the inspection

    • yes they are functional
    • no they are not functional
    • they are intermittent

  • Modifications

    • installed gear tray and isolator
    • installed 4mm and 6mm from joint to gear tray
    • installed slip base pins and clamps
    • installed SBM retrofit gear tray as per RFI0068

  • Photo of completed works showing all modifications

  • Comments and any additional works required

  • QML representative to sign

LMS1 EXISTING POLES revb
CB Energy

LMS1 EXISTING POLES revb

Pole upgrade record

Use this Template
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.

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