Information
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Audit Title
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Site Details
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Asset ID number for YEDL only
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System voltage
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Pole Number
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Please take a photo of the pole to be changed
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Name of S/S where the supply is fed from
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Number of S/S where the supply is fed from
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Pole type
- Intermediate
- Pin Angle
- Section
- Section Angle
- Terminal
- Tee
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Pole size
- 9m
- 10m
- 11m
- 12m
- 13m
- 14m
- 15m
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Pole girth
- Light
- Medium
- Stout
- Extra Stout
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Network main line configuration
- 2 Wire
- 3 Wire
- 4 Wire
- 5 Wire
- ABC
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Network main line conductor size
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Network tee line configuration
- 2 Wire
- 3 Wire
- 4 Wire
- 5 Wire
- ABC
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Network tee line conductor size
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Give details and number of O/H services which are fed from pole
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Give details and number of U/G services which are fed from the pole
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Mains cable size details
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Is a jointer required
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Will street lighting be affected
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If there is a streetlight will it require
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Is there any BT equipment on the pole
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Will BT be required to remove/replace their equipment
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What method of excavation will be used
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Ground type at pole base
- Road
- Tarmac fpath
- Grass verge
- Field (crop on)
- Field (crop off)
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Land ownership
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Please take a photo of the access route if required
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Is a road opening notice required
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Is a road closure Required
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Are temporary traffic lights required
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What is the speed of the road
- 20
- 30
- 40
- 50
- 60
- 70
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Is a HV outage required?
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Is the work in the vicinity of Network Rail equipment or property
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Have you confirmed the network open points that will affect the work
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If yes, please take a photo of all open points
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Second photo if required
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Are there any other points to note or hazards that you have idetified
Please give details of the isolation requirements
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Add details here
Any additional information
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Add details here
Owner/Occupier agreement for works to be undertaken
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Owners name
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Owners address
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Owners telephone number
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Occupies name
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Occupiers address
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Occupiers telephone number
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Describe the proposed works
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Please add a sketch of the works area
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Surveyors name and signature
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Owners name and signature
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Date of signing
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Occupiers name and signature
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Date of signing
Material requirements
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219642 Steelwork, Lv Fitting, "D" Iron Pin and Split Pin, Pre Assembled
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261222 Ironwork, Flat Strap, Lv Extension for Neutral Bar to Drawing Number 1.00.043.9504 Sheet 1
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253917 Insulator LV Reel Brown Porcelain
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- 7
- 8
- 9
- 10
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253866 Coachscrew Service Insulator
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- 8
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378544 M16 x 50mm Bolt Galvanised
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378582 M16 x 130mm Bolt Galvanised
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378629 M16 x 220mm Bolt Galvanised
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378633 M16 x 260mm Bolt Galvanised
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378652 M16 x 300mm Bolt Galvanised
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378671 M16 x 400mm Bolt Galvanised
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378794 M20 x 300mm Bolt Galvanised for use with Stay Plate
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368078 M20 Curved Washer
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378987 M16 Round Washer Galvenised
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237134 LV Stay Plate
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244922 Stay Thimble
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225367 LV Stay Top Preform (For Use With Stay Plate)
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248232 Stay Insulator
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255217 Stay Make Off Preform
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261970 Yellow Stay Guards
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231481 Stay Wire
- 5m
- 10m
- 15m
- 20m
- 25m
- 30m
- 35m
- 40m
- 45m
- 50m
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242611 Duckbill Anchors
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226225 Strut Bar
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220228 Stay Outrigger
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226175 Stay Rod
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217448 Stay Barrel Turnbuckle
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235124 Stay Baulk
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223966 16mm Copper Deadends - HDBC
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251343 16mm PVC Covered Copper Deadends
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251292 32mm Copper Deadends
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223859 32mm PVC Covered Copper Deadends
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251254 32mm Copper Inter Ties
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229088 32mm PVC Covered Copper Inter Ties
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251305 70mm Copper Deadends
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223867 70mm Copper Deadends
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223867 70mm PVC Copper Deadends
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- 9
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231235 70mm Copper Inter Ties
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229096 70mm PVC Covered Copper Inter Ties
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251324 50mm Aluminium Deadends
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251288 50mm Aluminium Inter Ties
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251339 100mm Aluminium Deadends
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251269 100mm Aluminium Inter Ties
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- 2
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- 8
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223883 16mm Solid Copper Dead End Preform
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223891 35mm Solid Copper Dead End Preform
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260431 Deadend Preform 25-35mm Concentric
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255344 Deadend Preform 35mm Split Concentric
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255202 Deadend Preform 25mm Split Concentric
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072652 Compression Fitting Non Tension - VPAN 1.1
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242388 Insulated Service Connector 4-35mm to 4-35mm Cu or Al
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077362 Compression Straight Tap Connector 25-70mm Cu Main with 10-35mm Copper Tap Ref VPCTC 2.2
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Compression 'L' Tap Connector 32-150mm Cu main with 50-90mm Tap Ref VPCTC 3.4
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Site Specific Risk Assessment
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1. Do all team members hold a relevant Safety Passport documentations/authorisations with a least one member NRSWA & First aid trained?
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2. Have all manual handling tasks been addressed by Risk Assessment and operatives capability confirmed?
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3. Does this Risk Assessment cover all activities taking place on site including any Enviromental impacts?
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4. Are all components of the team safety pack curt and available on site
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5. Have al