• Service Order number

  • Address

  • Conducted on

  • Prepared by

  • Location
  • Tech/Company


  • What has caused the issue encountered? (End Customer, Third Party, Technician, Deterioration)

  • Trouble Found Code:

  • Which piece of network is damaged? (26Way, 100mm, 50mm, Clamshell, etc)

  • UN Fault Category:

  • What is the issue? (Faulty/blocked duct, blocked Ribbonet, Tapes Jammed or missing)

  • Where is the issue? What is required to repair issue?

  • What is the specific location of each issue encountered. (eg in front of 10 Bob St)
    What tasks where performed at each location. Ex Dig and fix of 100mm duct outside 10 Bob St.

  • ADD Photos of issue and work completed:

  • Was Hard surface Reinstatement Required?

  • Please provide Panel measurements and surface type (Plain Brush/Exposed Aggregate/Oxide (Red, Brown, Black)/Tarseal/Cobbles

  • Please add Pre-Start, Temporary and Permanent Photos

  • General Comments

  • What was done to resolve the issue? Any extra information deemed relevant (Level 2 road, Pot holing required, Arborist)

  • Codes Claimed:

  • Codes claimed Ex: MC12x1…etc

  • CM Approval Number for UN work

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.