Title Page
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Site conducted
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Engineer Name
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Conducted on
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Location
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Customer Number
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Works Completed?
Completion Evidence Report
Permits
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Is this OH or UG?
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Number of spans from MST/CBT
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Assist/hoist? Please type Hoist/Assist/None
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Has the permit to dig & POWRA been completed for works?
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Is the excavation in public under a permit or in private?
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Has the permit been started and closed?
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Surface type (Select all that apply)
- C/W
- F/W
- Tarmac
- Concrete
- Pavers
- Slabs
- Soft
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Measurements of dig
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Light test reading at MST completed (Include pictures)
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Light test reading completed on Cable (Include pictures)
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Length of cable pulled (Include pictures)
- 50
- 100
- 150
- 200
- 250
- 300
- 350
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Duration of works (HH:MM)
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Any additional information?