Lwf electrical - start card and sign off form 3 - 24.8.16

• Tow number:

• Customer address:

• Materials list:

  Select 20ext 30ext 40ext 60ext 80ext 120ext 200ext 300ext 500ext pcd 1ftc 2ftc 3ftc 4ftc 3int 5int 10int 15int 20int 30int 50int pig tail & clamp riser bracket & clamp cable clamp 10tape 15tape 20tape 25tape 1 s/plate 2 s/plate 3 s/plate 4 s/plate 5 s/plate 1 l/plate 2 l/plate 3 l/plate 4 l/plate 5 l/plate through connector roll of internal fibre 60m roll of internal fibre 80m roll of internal fibre 100m roll of internal fibre 120m roll of internal fibre 150m

  • 20ext
  • 30ext
  • 40ext
  • 60ext
  • 80ext
  • 120ext
  • 200ext
  • 300ext
  • 500ext
  • pcd
  • 1ftc
  • 2ftc
  • 3ftc
  • 4ftc
  • 3int
  • 5int
  • 10int
  • 15int
  • 20int
  • 30int
  • 50int
  • pig tail & clamp
  • riser bracket & clamp
  • cable clamp
  • 10tape
  • 15tape
  • 20tape
  • 25tape
  • 1 s/plate
  • 2 s/plate
  • 3 s/plate
  • 4 s/plate
  • 5 s/plate
  • 1 l/plate
  • 2 l/plate
  • 3 l/plate
  • 4 l/plate
  • 5 l/plate
  • through connector
  • roll of internal fibre 60m
  • roll of internal fibre 80m
  • roll of internal fibre 100m
  • roll of internal fibre 120m
  • roll of internal fibre 150m

Customer Details

• Installation Date

  Date

• Has the customer agreed with the location of the NTD or PCD?

  Yes

  No

  N/A

• Is the customer satisfied with the workmanship of the installation?

  Yes

  No

  N/A

• Upload Supporting Photos Here

  Media

• Any further comments or information? Brief description of what was done if a Nara service, service restoration etc:

• Serial Numbers:

• Mud map for ^80 or link pipes etc or take photo of whiteboard Mud map for ^30 internal cable claim

  Drawing

Sign-Off

• Contractors Signature:

  Sign

• Customer Signature:

  Sign