Title Page

  • Job ID:

  • Tech Name:

  • Tech ID:

  • Account #:

  • Conducted on

  • Prepared by

  • Location

Aerial Installations

  • Proper Mid-span attachment

  • Span clamp placement

  • J hook and P hook

  • Drop Hanger Attachment

  • Pole/Routing Clearance

Underground Installations

  • Proper installation of drop/Slack

  • HouseBox Installed

  • Grounding/Per BRIS Standards

  • Drop Guard/Slip Pipe

  • Proper installation of Drop Guard

  • Yard Cleanup/Restoration

Installation/Workmanship

  • Inside routing

  • Proper tagging procedures/LTO Tag

  • Traps Removed

  • Approved Materials/Splitters

  • F-Fittings/connectors/Weather protectors

  • Appropriate cable used/RG6/RG11/Aerial

  • Outside cable routing/fasteners/silicone

  • 75 ohm terminators

  • Wall plate and jumper dual jack

  • Inside cleanup

  • RFI signal leakage

  • Service loops

  • Phone jacks

Customer Equipment

  • Levels @ customer's equipment:

  • Return path connectivity

  • All equipment installed and operating properly

  • Work order completed accurately

  • Alarm (if applicable)

Customer Feedback

  • Installation Package Explained

  • Technician (Behavior; Appearance; ID; Vehicle Condition)

  • Customer satisfied with job

  • Customer satisfied with product quality

  • Technician explained survey

Services

  • Service Types

Packages

  • Package Types

  • Comments:

  • Any available pictures:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.