Information
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Address
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Commit Date
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Prepared By
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Conducted on
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Job number
Next Actions
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Was a half scope or full scope completed?
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Skill set Required?
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Civil required?
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What Civil Skill set removed?
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Distance of trenching?
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Other requirements ? .i.e TMP, Arborist
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Customer consent granted? Written, verbal or both
Customer/ Job details
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Name
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Contact
Civil Required
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Detailed description of civil works required
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Add labelled photos
Health, safety and environmental issues
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Under floor access?
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Ceiling access?
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Location of ETP
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Gas detector required
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Dogs on site
Consent required
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Right of way?
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Multi dwelling unit
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Heritage site or building
Network
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50mmP drop off correctly installed?
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Water in chambers?
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Tapes in place?
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Tapes moving?
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Tapes connected to correct FAT?
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FAT location?
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Cabinet location?
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Distance from FAT (fixed) or Cabinet (ABF) to boundary?
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Distance from boundary to ETP
Internal Information
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WYAH material?
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Preferred location of ONT
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Preferred location of RGW?
Additional notes
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Notes
Outside property consent
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Hole excavation and trenching?
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Removal of concrete/tiling/pavement?
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Installation of conduit(s)?
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Removal of existing copper line to the house?
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Others?
Inside property consent
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Drilling small holes?
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Cutting holes in walls?
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Exposed surface wiring?
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Removal of ceiling tiles?
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Surface mounted installation and hardware?
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Others?
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Signed consent
I confirm that:
-I have seen, read and understood this information and the end user terms and accept those terms; and
-if I am not the owner of the property, I have obtained the consent of the owner for the installation works; and
I understand that there may be an impact on the operation of burglar and medical alarms, particularly monitored alarms. [ Note: check with your alarm provider or telecommunications service provider]
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End user signature:
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Authorised chorus technician:
Media
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Add media
