Pole Installation Audit (CFH Asset)

• 

• OHSF-PR-08-13 Version 1 Revision 2 Dated 21/01/2021

• Conducted on

  Date

• Name of the person carrying out audit

• Location
  Address

• Pole reference number and address, for example, (PN1- SN2 outside church street)

• Link to Pole Guidance https://cityfibreholdings.sharepoint.com/sites/83f32dad-9d7a-4eac-83c0-87eddf67073f/Shared%20Documents/Forms/AllItems.aspx?id=%2Fsites%2F83f32dad%2D9d7a%2D4eac%2D83c0%2D87eddf67073f%2FShared%20Documents%2FPole%20Installation%20Safety%20Check%2FAudit%20for%20New%20poles%2Epdf&parent=%2Fsites%2F83f32dad%2D9d7a%2D4eac%2D83c0%2D87eddf67073f%2FShared%20Documents%2FPole%20Installation%20Safety%20Check

• Link to PEA_FG_015_V1.1 specification- https://thecore.cityfibre.com/Interact/Pages/Content/Document.aspx?id=3350&SearchId=83336

• Prior to conducting the audit, please ensure you have familiarised yourself with the Pole Planting Manual for Build Assurance Quality Procedures
  https://cityfibreholdings.sharepoint.com/:b:/r/IMS/QMS/Shared%20Documents/Build%20Assurance/QMSF-PR-08-08-05-08%20CF%20Pole%20Planting.pdf?csf=1&web=1&e=VwqeXl

Pole planting audit

• Is the area safe to undertake the audit?

  Yes

  No

• Please comment why?

• Who is the main contractor for the build area?

  Select

• Are you assessing a newly planted pole or replanted pole due to remedial work?

  Newly Planted Pole

  Replanted Pole

• Who is the sub-contractor planting the pole?

• Has the proposed area for excavation been marked up in accordance to HSG 47 safe dig requirement’s?

  Yes

  No

  Not seen

• Is the site set up in accordance with the code of practice for Safety at Street Works and Road Works (Red Book)?

  Yes

  No

  Not seen

• Photo required

  Media

• Are the HA permit conditions being complied with?

  Yes

  No

  Not seen

• Is the pole erected on the property boundary? (take photo of pole in relation to the surrounding area) in accordance with PEA_FG_015_V1.1 specification

  Yes

  No

• Is pole erected kerb side in accordance with PEA_FG_015_V1.1 specification

  Yes

  No

• If yes is it minimum 500mm from face of kerb to pole?

  Yes

  No

• Photo required

  Media

• Where is the Pole sited?

• Photo required

  Yes

  No

• Is there 1 metre unobstructed passage for pedestrians in accordance with PEA_FG_015_V1.1 specification

  Yes

  No

• record measurement

• Photo required

  Media

• Is the pole erected in immediate vicinity where young people gather i.e. school or community centre?

  Yes

  No

• Is the pole a creosote preserved pole, steel, or other?

  Creosote preserved

  Steel

  Other

• What type of pole is it?

• Is the pole bleeding creosote?

  Yes

  No

• Is the pole protected with hessian sacking in accordance with PEA_FG_015_V1.1 specification?

  Yes

  No

• Is the pole erected near spiked railings or other hazards?

  Yes

  No

• Has the appropriate hazard label been fitted to the pole?

  Yes

  No

• Photo required

  Media

• Are steps aligned correctly to ensure safe ladder access is maintained in accordance with PEA_FG_015_V1.1 specification?

  Yes

  No

• Photo required

  Media

• Is the ASN fitted correctly to the pole?

  Yes

  No

  Not Fitted

• Photo required

  Media

• Is the ASN bracket fitted correctly to the pole?

  Yes

  No

  Not Fitted

• Photo Required

  Media

• 

• What length of pole has been erected

  Select 7 8 9 10 11 12 13 14 15 other

  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • other

• What is the pole length?

• 

• What is the class of the pole?

  L = Light

  M = Medium

  S = Stout

• 

• What is the year of preservation?

  Select 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030

  • 2018
  • 2019
  • 2020
  • 2021
  • 2022
  • 2023
  • 2024
  • 2025
  • 2026
  • 2027
  • 2028
  • 2029
  • 2030

• 

• What is the manufacturer ID?

  2 (Two)

  3 (Three)

  Other

• Please provide the manufacturer ID.

• 

• What is the Timber Species?

  I

  Other

• Please provide the Timber Species.

• Soil classification in accordance with PEA_FG_015_V1.1 Specification?

  Good/Average

  Poor

  Rock

  Not Known

• was the excavation created bay hand evacuation or mechanical auger excavation?

  Hand Excavation

  Mechanical Auger

• Was/Is the excavation hand excavated down to 1.1 metres

  Yes

  No

  Not seen

• Is the pole installed to the correct depth as specified in accordance with PEA_FG_015_V1.1 specification (including rock dig)?

  Yes

  No

• Record the length of pole depth buried

  Select 1.7 1.8 1.85 1.9 2.0 2.1 2.15 2.2 2.3 Rock Dig Other

  • 1.7
  • 1.8
  • 1.85
  • 1.9
  • 2.0
  • 2.1
  • 2.15
  • 2.2
  • 2.3
  • Rock Dig
  • Other

• Please record the depth the pole is buried

• take an image of pole markings and an image of measurement against the birth mark/3-metre mark

  Media

• Please record the depth the pole is buried

• Has the pole conduit tube been installed at the base of the pole?

  Yes

  No

• If yes record the measurement using the pole gauge by taking a photo

  Media

• you must escalate this to the delivery team and inform your local SHEQ Advisor.

• Does the pole conduit 3mtr measuring rod line up to the birth mark/3mtr mark?

  Yes

  No

• Photo required

  Media

• Please record measurment

• Is the pole visible look loose/moving at the base or out of vertical?

  Yes

  No

• Photo required

  Media

• Has the pole been erected next to a slope or embankment in accordance with PEA_FG_015_V1.1 specification?

  Yes

  No

  N/A

• If yes has it been erected in accordance with 11.3 figures 9, 10, 11, 12, 13.

  Yes

  No

• Photo required

  Media

• Is the pole clearly marked CityFibre and etched CF on the pole? (Not defaced or altered)

  Yes

  No

• What marking is on the pole?

• Photo required

  Media

• Is the laminated CityFibre statutory notice letter fixed to the pole? (the notice document <br> number PEA_ED_001 can be found https://thecore.cityfibre.com/Interact/Pages/Content/Document.aspx?id=2665&SearchId=83962 )

  Yes

  No

• Photo required

  Media

• Has the (yellow label) Caution Fibre Overhead label been fitted?

  Yes

  No

• Photo required

  Media

• Has the (silver disk) CE marked label been fitted?

  Yes

  No

• Photo required

  Media

• Auditors signiture

  Sign