Title Page
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Project Name : Site
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Prepared by
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Site Name (Facility ID / Name)
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Location / Address
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WO number
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Conducted on
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Install team
SAFETY / RISK
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If Site Crew is onsite working; ensure JSEA/JHA and Permit to Work are being used.
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Are all risks being controlled as specified in JSEA/JHA?
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Identify the level of traffic risk involved by accessing this chamber?
- Very low (side street / garden bed)
- Low (footpath)
- Medium (side street corner)
- High (main road / heavy traffic)
- Very High (main road intersection)
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Are you aware of the manual handling risks involved and have they been addressed?
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Is there a possibility of exposure to sharps?
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Is the chamber lid(s) / cabinet easily lifted
Audit Scope
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Inspection covers: Full install; Civil install only; IoT/Sensor/Comms install only
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Pole Install concreted in place / bolted adequately
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Conduits installed correctly; sealed; backfilled; draw wire; shielded above ground.
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Solar panel fixed to top of pole and set to approx. 33 degrees. (photo evidence required: picture of solar panel serial # and make / model number.
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IoT comms installed neatly within cabinet (photo evidence required: photo of IoT comms device, including serial # and make / model number.
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Pressure Sensor is installed with no leaks visible; cable management/neat (photo evidence required: Include photo showing closeup of make/model and serial #)
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Aerial is installed neatly and connected to grounded structure?
COMMUNICATIONS (IoT)
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Have the communications been commissioned, or tested for connectivity?
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Any other final comments / photos - INSERT HERE
