Title Page

  • Conducted on

  • Location
  • Project Number

  • Customer Power on Date

  • Customer Contact Details (Preference)

  • Temp Check

  • Vulnerable Customer

  • Job Type

  • Date & Time of Visit

  • Construction Coordinators Name

  • TM Type & Requirements

  • TM Other

  • Cable Length

  • Cable Type

  • Customer Requires Call Back

  • Date Customer Requires Call Back

  • Comments

  • MPAN Available

  • Customer Aware of Next Steps

  • TTRO / Traffic Management Identified

  • *Expected Traffic Management in Place

  • *Customer Signature

  • Date of Signature

  • Construction Coordinator Signature

  • Date of Signature

  • Photos

Checklist

  • OSVC

  • Hockey Stick

  • Duct

  • Sand

  • Tape

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.