Title Page
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Survey Reference
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PON Reference Number
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Installation Building Name
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Installation Address
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Installation Post Code
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Conducted on
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Prepared by
Onsite Details
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Onsite Contact Name
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Onsite Contact Telephone Number(s)
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Onsite Contact Email Address
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Is the building Pre 2000?
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Is there an Asbestos Register onsite?
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What is the size of the MDU?
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Where are we proposing to locate the CBT/Splitter/BUDI Box?
External Survey Details
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How are we proposing to feed the premise?
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How many OH spans from the first pole to the premise are there?
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Is the first pole a DP or CP?
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Have you tested all the poles?
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Are any of the poles defective or not useable?
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Are any of the poles on Private Land?
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Will Traffic Management be required?
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Provide any additional information
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Photo Gallery
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Is the civils work on Private Land, Public Land or Both?
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How many Metres of duct 54mm in Soft is required?
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How many Metres of duct 54mm in Footway is required?
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How many Metres of duct 54mm in Carriageway is required?
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How many Metres of duct 96mm in Soft is required?
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How many Metres of duct 96mm in Footway is required?
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How many Metres of duct 96mm in Carriageway is required?
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Are any chambers required?
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Will Traffic Management be required?
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Provide any additional information
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Photo Gallery
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Has the Openreach Lead-In been Test Rodded?
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Has the Openreach Lead-In been Roped?
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Are there any blockages in the Lead-In?
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Has an A55 been raised?
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Has any other part of the Openreach Network been Test Rodded?
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Has any other part of the Openreach Network been Roped?
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Will Traffic Management be required?
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Provide any additional information
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Photo Gallery
Internal Survey
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Has an Internal Survey been carried out?
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Is there a dedicated Comms Room?
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How many floors are there?
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How many Apartments are there on each floor?
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Are there any Riser Cupboards or Risers?
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Are there any External holes that need to be drilled?
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Are there any Internal holes that need to be drilled?
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What size of internal fibre cable(s) will be required?
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How many Metres of cable will be required?
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Will Tray and Trunking be required?
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Provide additional information that will be useful to the Internal installation
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Please supply all un-annotated photos here
