PRE IV VERIFICATION WALK

• Conducted on

  Date

• Prepared by

• Location
  Address

INFORMATION

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  Address

• Select date

  Date

DEFECT CHECK

• PIT CLEANED?

• PIT CLEANED

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• CONDUITS CAPPED?

• CAPPED CONDUITS

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• J-BELL LABELED?

• J-BELL LABEL

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• J-BELL LOOPS AND HOLDER?

• J-BELL LOOPS AND HOLDER

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• CONDUITS SEALED AND TRIMMED?

• SEALED AND TRIMMED

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• FIBRE CABLE LABELLED?

• FIBRE LABEL

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PROVIDE DETAIL INFORMATION BELOW

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