Irtiza Mumtaz

NGA ROW Field Visits

Form to be completed on every NGA job and emailed to the ROW Mailbox

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Print as PDF

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Information

Viscore ID:
Address
Prepared by

ROW Scope Check List & Decision Tree

Connection Type
How many houses down this ROW
MDU/ROW Class 1
MDU/ROW Class 2
MDU/ROW Class 3

Scoping Details

Was the design followed?
Identify what was the change and why the plan was not followed
Any other observations/comments
Add photos for design. Blue - existing; Red - build; Purple - future or for provisioning.
Additional Notes

Irtiza Mumtaz

NGA ROW Field Visits

Form to be completed on every NGA job and emailed to the ROW Mailbox

Use this Template

Print as PDF

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