NGA Scoping Form - V.DT

• S/O Number

• Address

• Prepared by:

Job Details

• Appointment time

  AM

  PM

• What work type is to be completed?

  Select 1. Aerial (560) 2. Haul (561) 3. Surface Mount (562) 4. Trench (563) 5. Drill or slot Trench in Concrete (564) 6. Hard Surface Trenching (565)

  • 1. Aerial (560)
  • 2. Haul (561)
  • 3. Surface Mount (562)
  • 4. Trench (563)
  • 5. Drill or slot Trench in Concrete (564)
  • 6. Hard Surface Trenching (565)

• Chorus approval required

• Type of network?

  Select Air Blown Fiber Fixed Fiber Haul Aerial (overhead)

  • Air Blown Fiber
  • Fixed Fiber Haul
  • Aerial (overhead)

• Distance

Job instructions

• Netmap or Lay plan

  Media

• Other photos

  Media

• Detailed description of works required

Health, Safety and Environmental Issues

• Other requirements? I.e TMP, Arborist

  Select No L2 TMP Arborist Obstruction plans required Other

  • No
  • L2 TMP
  • Arborist
  • Obstruction plans required
  • Other

• What is required?

• Gas detector required?

  Yes

  No

  N/A

Additional notes

• Notes