Pole Inspection Form - V6

• Your name

• Date of inspection

  Date
• Location - stand next to pole when selecting and enable GPS
  Address

General details

• What type of pole structure is this?

  Single

  Double

  H Structure

• What is the pole material?

  Concrete

  Hardwood

  Softwood

• What is the pole condition?

  Green

  Amber

  Red

• Is there any vegetation nearby this pole?

  Select This pole has no nearby vegetation that could be an issue. This pole has nearby vegetation, that is currently not an issue. Vegetation is an immediate issue for this pole or nearby lines.

  • This pole has no nearby vegetation that could be an issue.
  • This pole has nearby vegetation, that is currently not an issue.
  • Vegetation is an immediate issue for this pole or nearby lines.

• Describe the type of issue and take photos to support this.

• What is the asset number?

• Is there signage?

  Yes

  No

• Is there a Possum Guard

  Yes

  No

• Can you determine the Landowner Details?

  Yes, Owner is Known

  No, Cannot Determine

• What Are the Landowner's Name & Phone Number?

Crossarm Assessment - Create one per level

• What level is this arm

  L1

  L2

  L3

• What is the assembly type?

  Single Pin

  Double Pin

  Strain

• What is the Crossarm material?

  Wood

  Steel

• What is the crossarm condition for this arm?

  Green

  Amber

  Red

Stay Assessment

• What is the condition of the stay?

  Green

  Amber

  Red

  N/A

Any additional comments or photos you would like to add?

• Please add them here: