Information

  • CSA

  • Job Number

  • Auditee name

  • Address

  • Conducted on

  • Auditor Name

  • Contract Manager

Sign off information

  • Services & testing completed as required in service order memo

  • Network Locations where work was carried out has been recorded in sign off

  • Location where service was confirmed working

  • 9.011 Records updated

3 Service Order

  • 3.004 NTS test results OK (Techmate)

4 Codes

  • 4.004 Correct Statement of Work codes used

5 Fault

  • 5.009 Escalation procedure followed (Network improvement Form)

9 MDF

  • Was any work completed at this location by Technician?

  • 9.005 Jumper routing via frame guides

  • 9.006 Jumper type correct (OR/WH) with required (200mm) slack left

  • 9.008 Solder jumper terminations correct (wire strip & wrap, no excess solder)

37 Passive Copper Cabinet

  • Was any work completed at this location by Technician?

  • 37.008 Cabinet Jumper correct type (White/Blue)

  • 37.009 Cabinet Jumper run correctly (50mm slack & no excess)

  • 37.016 Locks & hinges OK (NIF Submitted for damage)

  • 37.019 Cabinet Jumper terminated correctly

39 Aerial Terminal

  • Was any work completed at this location by Technician?

  • 39.002 Terminal mounted and secured correctly

  • 39.004 Terminal lid secure

  • 39.005 Terminal label on lid or plate on pole

40 Pillar Terminal

  • Was any work completed at this location by Technician?

  • 40.01 Correct connectors used

  • 40.002 Pillar ID correct

  • 40.003 Lid secure (2 screws)

  • 40.005 Plastic bags installed & secure (2 bags/2 cable ties)

  • 42.008 Foam bung fitted

  • 40.012 Service Lead labelled correctly

  • 40.013 Unused pairs capped

  • 40.016 Encapsulated loop resealed correctly

  • 40.019 Service Lead - flying leads installed and correct

41 BDD Terminal

  • Was any work completed at this location by Technician?

  • 41.001 Pit lids secure/locked

  • 41.003 Radi: Base & lid clean, O ring seated correctly, O ring replaced upon entry

  • 41.004 O/J lid labelled

  • 41.008 Plastic bags installed & secure

  • 41.013 Service Lead labelled correctly

  • 41.014 Unused pairs capped

  • 41.016 Faulty connectors replaced (Green/Milky connectors must be replaced)

  • 41.019 Service Lead - flying leads installed and correct

42 Pedestal/ Internal Terminal

  • Was any work completed at this location by Technician?

  • 42.003 Lid secure

  • 42.004 PDS network labelled correctly

  • 42.008 Foam bung fitted

  • 42.011 Service Lead labelled correctly

  • 42.012 Service Lead terminated correctly

  • 42.013 Unused pairs capped

43 Aerial Service Lead

  • Was any work completed at this location by Technician?

  • 43.001 Correct Service Lead used

  • 43.003 Tension, sag and twist correct

  • 43.004 Correct pole fittings used and installed (screw eyes, sash clamps)

  • 43.013 Servi seal secured in upright position and Gel Snap secured horizontally

45 ETP

  • Was any work completed at this location by Technician?

  • 45.004 Aerial lead in to ETP correct eg termination hardware, position, tidy appearance

  • 45.005 20mm pipe to ETP is white only

  • 45.006 20mm pipe end (within ETP) is sealed with silicone and drainage holes left clear

  • 45.008 Premise cabling exit from ETP is sealed with silicone

  • 45.016 Unused pairs capped

General Task waste

  • 73.024 Site Tidy, no task waste remaining

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.