Title Page
JOB INFORMATION
-
Client
-
Job #
-
Date and Time
-
Field Engineer
-
Address
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Grounded
-
Bonded
POLE INFORMATION
-
Photo #s
-
Ground Line Circumference
-
Pole Sequence #
-
Pole Tag #
-
Pole Condition
-
Pole Address
-
Pole Class
- N/A
- 7
- 6
- 5
- 4
- 3
- 2
- 1
- H1
- H2
- H3
- H4
- H5
- H6
-
Pole Height
- 25
- 30
- 35
- 40
- 45
- 50
- 55
- 60
- 65
- 70
- 75
- 80
-
Pole Species
- WC
- WP
- JP
- LP
- NP
- DF
- SP
- WL
-
Transformer Size
- None
- 10kv
- 15kv
- 25kv
- 37.5kv
- 50kv
- 75kv
- 100kv
- 167k
- 250kv
- 333kv
- 500kv
- Unknown
-
Capacitor Bank
-
POLE SKETCH (pole, spans & length, achors) (number corresponding to table below)
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PROFILE POLE SKETCH
ATTACHMENT INFORMATION
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Telco, CATV, other fiber, streetlight, secondary power
Attachment
-
Attachment Type
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Existing HOA
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Proposed HOA
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# of Cables
-
Strand Size
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Arm Position
ACHORD AND DOWN GUY INFORMATION
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Anchor
-
Photo
-
Surface
-
Eyes
-
Size
- 1/2
- 5/8
- 3/4
- 1
- 1.25
- Buried
-
Lead
Down Guy Size (2m, 6m,10,16m,25m)
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Power
-
Telco
-
CATV
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COMM
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Queens Height
NOTES
-
Remove Pole Steps
-
Tree Triimming
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Approx (ft.)
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Between P
-
and P
-
Pole Removal Needed
-
Pole Transfer Needed
-
Existing Attachments need to be removed
-
Poel not accessible
-
Notes