Patroller Survey Suriname - duplicar

• MAP ID and Sierra Pole ID

• Street/Address

• Conducted on

  Date

• Prepared by

POLE DETAILS

• Pole GPS location (approximate)
  Address

• Pole Photographs

  Media

• Sierra Map Pole ID

• Power Company Pole ID

• Pole Type

  Power Pole

  Joint Use

• Pole Construction Type

  Wood

  Concrete

  Steel

• Existing Cable Angle <20°

  Yes

  No

  N/A

• Pole Diameter

• Pole Voltage

  HV

  LV

• Comments

GENERAL SITE DETAILS

• Can the pole be accessed safely?

  Yes

  No

  N/a

• Is the Bucket Truck Required to access the pole?

  Yes

  No

  N/A

• Does Electricity company need to be informed of any safety critical hazards?

  Yes

  No

  N/A

• Is a Traffic/Pedestrian management plan required?

  Yes

  No

  N/A

• Is there adequate space on the pole for proposed network cable?

  Yes

  No

  N/a

• a) under 4.3 meters form HV line or 1.7m for LV line?

  Yes

  No

  N/a

• b) 20.3 cm measured vertically below the lowest cable?

  Yes

  No

  N/a

• c) Not be less than 6.0m over roads or 5.0m above property or 5.0m in positions inaccessible to vehicular traffic.

  Yes

  No

  N/a

• d) Not erect any poles within a radius of 2.5m of an existing pole ,or line with equipment/lines rated at 12kV and below?

  Yes

  No

  N/a

• Is there a possibility of stray voltage from visual inspection?

  Yes

  No

  N/A

• Are there any Poles with broken earths, not to be climbed?

  Yes

  No

  N/A

• Are power and telco stay wires fitted with an insulated knuckle?

  Yes

  No

  N/a

• Does the pole need to be replaced?

  Yes

  No

  N/A

• Are there beehives or nests on the pole?

  Yes

  No

  N/A

• Are there any underground connections on the pole?

  Yes

  No

  N/A

• Any additional hazards identified? (add as necessary)

Hazard

• Hazard Details

• Additional Site Notes/Comments

• Patroller Signature

  Sign