Title Page
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Site conducted
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PM#
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Notification #
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SAP Pole ID#
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Please ensure SAP ID# matches information in MAPS+
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Veg Tag #
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Circuit #
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Pre-Fielder
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Conducted on
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Location
Field Information
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1. Is this a Cancelled A location?
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2. What is the Canceled A scenario? (Please Include Pictures)
- Common Neutral
- Done on Arrival
- No Surge Arresters
- Tap Line Removed
- Primary Cut
- Primary Riser
- Absence of Transformer
- Absence of Pole
- Customer Denial
- De-Energized Location or No Service
- Duplicate Pole
- Pole Replacement Tag Found
- Unsafe Pole
- Other
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Are you QEW Certified?
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If QEW certified, please explain condition of pole to support 'Unsafe Pole' status and Please include pictures (IE Pole rot, Severe Cracks, Woodpecker Damage, 10% Lean, Fire Damage):
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Please flag this notification for QEW certified personnel to inspect this pole and deem it 'Unsafe'.
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Please make sure to write out EC tag for Unsafe Scenario of pole.
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Please identify type of tag and include a picture:
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Please briefly explain the CA scenario:
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2. Upon accessing the location, were there any obstacles present? (Trees, un-crossable bridge, road washed out, etc.)
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Please explain in detail any obstacles observed and pictures to support:
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Did you have to hike to the pole?
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How long was the distance? (approximate feet, yards, etc.)
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3. Are there dog(s), pet(s), or any other animals present on the property?
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Please capture info in MAPS+ and let customer know that if they have animals present near the work area, they will be asked to lock them up.
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Please explain in detail what animals are present and what is their status:
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4. Was there face-to-face contact made with customer during pre-field inspection?
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Did you inform the customer of the work taking place at their property?
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Did you inform the customer that different departments might need to access their property in the future to fully complete scope of work?
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Was the customer confrontational or have an issue with work taking place on the property?
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Please capture info in MAPS+ as an alert.
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5. Will any adders be required?
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For each Adder selected add a photo to support it.
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Post Insulator Replacement (including existing cross-arm if applicable) - Does the pole have ceramic post insulators supporting weight of conductor spans (not jumpers)?
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Was the pole installed between 1968 - 1976?
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Please include replacement of the ceramic post insulators in the job scope.
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Concrete Restoration?
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Asphalt Restoration?
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6. Is there a gate code or multiple gate codes?
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Please list gate code or gate codes in detail:
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If gate code were to change, is there an alternative means for us to access the property?
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Please explain in detail what is the alternative method to gain access?
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7. Is pre-coordination required to perform work? (IE Vegetation Trimming, Landscape)
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Please briefly any items that require pre-coordination and include pictures:
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8. What type of delineations have been placed? (White paint, white ribbon, etc.)
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Please ensure a white "X" is placed above eye level at the pole.
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9. Is the existing Transformer protection non exempt?
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10. What type of riser is present? (Please include pictures)
- Electric Riser
- Phone Riser
- Cable Riser
- None
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11. Are there Gray Services?
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Are the gray services deteriorated / cracked /exposed?
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12. Any minor GO 95 infractions? (Please include pictures.)
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Please select all GO 95 Infractions and please include pictures (Only repairs/replacements that will take 15 minutes or less can be executed on day of Mobilization):
- Missing/Illegible High Voltage signs
- Missing or damaged visibility strips
- Exposed grounds
- Low conductor clearance
- Guy Indicators
- Missing or damaged guy markers
- Low or bent pole steps
- Bolt covers
- Items that restrict access
- Improper grounding
- Other
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Please briefly explain 'other' GO 95 infractions and please include pictures:
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Pre-Fielder's Signature
