Work Site Prestart Meeting Record

Section 1 - Work Order Details

Installations in Customer Premises NAT SCSWMS- 081

Mechanical Fibre Splicing NAT SCSWMS- 088

Other

The SWMS’s listed below are
relevant to this job and have been developed in consultation with
workplace personnel involved in the associated work activities.
They are to be read & understood by all personnel employed on this
job/project. All inductees are to acknowledge they have been
inducted by completing Section 3 over the page.

TOW#

Date

Company Name: THI KIM VAN LE Contact: Brandon Phan-Nguyen 0466 992 308

Work Site

Underground lead-in Installations at Customer Sites NAT SC-SWMS-080

Nearest Hospital

Princess Alexandra Hospital (07) 3176 2111

Royal Brisbane and Women's Hospital (07) 3636 8111

Ispwich Hospital (07) 3810 1111

Other

Work Description

Underground lead-in Installations at Customer Sites

Installations in Customer Premises

Safe Wortk Method Statement
High Consequence Hazards

1. Working near underground assets
(energised electrical installations, near
pressurised gas)

2. Working near Powerlines (LV/HV)

3. Working in a Confined Space

4. Working near powered mobile plant

5. Working on or adjacent to a road

6. Working near or adjacent to EME zones

7. Risk of falling more than 2 metres – refer
to the EWP RA

8. Working with Asbestos

9. Working on Telecommunications Towers

10. Excavation to a depth greater than 1.5
metres or wherever there unstable soil
conditions

11. Working on or adjacent to a railway

12. Working near water or other liquids
where there is a risk of drowning

Section 3 - Work Group Induction

Site Supervisor is to ensure all worksite
personnel are inducted to the following
requirements. (Tick when completed)

Scope of works

Relevant documentation (IFC plans, DBYD, etc.)

Site Control / Site specific instruction

Hazards and controls via SWMS’s and JSEA explained

Permits required

Site access and egress

Environmental management programs/issues

Grounds for suspension of work

Plant Management (Pre Starts & Exclusion Zones)

First Aid Kit & First Aider

Amenities

Hold Points (refer IFC Plans)

PPE Requirements

Inductees Acknowledgement

(Please Read Before Signing)
• Your signature below is your declaration that you have arrived to commence work today, fit for duty
(as per SC-HRM-PR016 Assessment of Fitness for Duty); and
• And confirmation that the controls in the RA’s / SWMS’s listed above and associated Site Specific
Risk Assessments (where applicable) have been understood and will be adhered to by all work personnel
involved, and that instructions provided by the site supervisor will be adhered to.

I certify that I have completed a Site Specific Hazard Identification, ensured required controls have been
implemented and all site personnel have been inducted.
If there are any visitors to the site their induction must be recorded on Visitors Induction form (SC-HSEFM-
0021).

Person Responsible for ensuring compliance with SWMS Company: THI KIM VAN LE PTY. LTD.

Site Supervisor’s Notes:
STEP 1 – List the locations that are applicable to this work order.
STEP 2 – Considering the work activities and referencing the Hazard Identification Check Sheet (HSEFM-
0001) list the SWMS used for each location/site.
STEP 3 – List High Consequence Hazards that are applicable to each site. Reference - Hazard
Identification Check Sheet (HSE-FM-0001). If the answer is N/A (Not Applicable) please provide further
details.
STEP 4 – Determine whether or not all hazards present at each location below are identified and/or
adequately controlled within the SWMS listed. If Not, a Site Specific JSEA (SC-HSE-FM-0002) is
required.

Inductee
Add signature

Work Site Visitor Induction

Section 1 –Site Details

Prior to entry to site all Visitors MUST be inducted and MUST sign this document to indicate the requirements of site has been presented to them and that they have an understanding of these requirements.

TOW#

Date
Location
Section 2 – Visitor Induction

Site Supervisor MUST ensure all visitors to this site are inducted to the following requirements.

Scope of works

Evacuation / Emergency Procedures & Assembly Point

Fire Extinguishers

Site Hazards

Site access and egress

Personal Protective Equipment

Non-Smoking Policy

Plant Management (Exclusion Zones)

First Aid Kit & First Aid Officer

Amenities (Nearest Toilet)

EEO Policy

Additional Information

Section 3 - Inductees Acknowledgement

The signatures below are confirmation that I have been inducted onto the site and that I am aware of the hazards and I will comply with all lawful instructions given to me by the Site Supervisor or their representative.

Inductee
Inductee Signature

Organisation

Purpose of Visit

Inducted By (Site Supervisor Signature)

EXTERNAL BUILD TOW FORM

Demand Drop External build TOW Form

TOW#

Site Address

Contact Name & Number

Notes

CUSTOMER SIGNOFF

I authorise Silcar Communications on behalf of NBN Co Limited to carry out work in order to connect the NBN network to my premises. I understand contractors will have to enter my property to undertake these works. The Silcar Communications representative has explained the work that is required on my property including the Property Entry Point (PEP), the aerial or underground lead in route and the location of the Premise Connection Device (PCD) on the side of my house. I have also discussed with the Silcar Communications representative any special requirements I have and any underground infrastructure that I am aware of in my front yard.

Signature
OFFICE USE ONLY

POLE ID:

Multiport ID:

Silcar Rep Name:

Port Number:

Drop code type: Underground

Estimated drop cable length:

PCD Location:

Way lead required:

Way lead obtained WL number

In Span Drop possible:

MDU Property :

Number of Units :

Riser Mast Req:

Riser Mast Size:

Riser Mast Type:

GNAF PID:

PIT ID:

TOW

TOW#

Date
Site Address

Contact Name & Number

Time Attended Site
Time Left Site

Test Results

Service Activation Reference #

Battery Back-up

Optical Budget expected range for 15km:
-23dBm Minimum & -13.9dBm Maximum

Can you proceed to complete this job
safely?

Non Standard Install Quote

Way Leave Consent

Spares Form

I agree the Work to the Premises and
installation of all NBN Co equipment was
completed to my satisfaction and at the
agreed location.

I have received the NBN User Guide and
Battery Backup Guide

Signature

LEAD IN PLAN

Aerial/Underground Drop Cable As-Built

TOW#

Draw Lead in Plan

Comments

Invoicing

Notes

Lead-in cable not installed

PCD not installed

C2-01-01-01-7.5MF Internals SDU (single dwelling unit)

C2-01-01-02-7.5MF Internals MDU (multi dwelling unit)

C1-02-01-01-7.5MF E2E in EXISTING conduit up to 80m route length and 30m of internal fibre cable

C1-02-01-02-7.5MF E2E in NEW conduit up to 20m of conduit on premises and 80m lead-in and up to 30m of internal fibre cable

C1-02-01-xx (existing) U/G lead-in only in EXISTING conduit up to 80m route length

C1-02-01-xx (new) U/G lead-in only in NEW conduit up to 20m

NA-01-01-01- Dirty ticket

C1-02-02-01-7.5MF- >80m route length external cable/ m

C1-02-02-02-7.5MF- Supply & install conduit >20m from P.E.P/ m

C1-02-02-05-7.5MF- Supply & install of conduit from pit to P.E.P/ m

C1-02-02-06-7.5MF- Supply & install of conduit in ROCK from pit to P.E.P/ m

C1-02-02-07-7.5MF- Installation of lead-in cable from AERIAL network to underground network at pole/ no. of pole risers

C1-02-02-09-7.5MF- Additional charge to install fusion splice

C1-02-02-10-7.5MF- Rectify blockage of, or repair an unfit LIC that would be otherwise held

C2-02-01-01-7.5MF- >30m length for internal fibre cable/ m

DI INVENTORY

TOW#

Internal NTD

Moulded Cable

Wall Mount

Indoor UPS Rev 'C'

Battery

Indoor NTD

Installation Material

WALL OUTLET ( optical) (SCA TO SCA)

NO POLISH SC/APC CONNECTOR SM FLAT SPLICE 250/900 8800-APC/FS

Realflex 3 drop cable single fibre SC/APC IVORY 500M drum

CORNING FURCATION TUBE KIT

Ofsoptics EZ Bend 1m SCA to SCA - low halogen

Ofsoptics EZ Bend 2m SCA to SCA - low halogen

Ofsoptics EZ Bend 3m SCA TO SCA - low halogen

Ofsoptics EZ Bend 5m SCA TO SCA - low halogen

PCD

Underground

CORNING OPTICAL DROP CABLE, 20M

CORNING OPTICAL DROP CABLE, 30M

CORNING OPTICAL DROP CABLE, 40M

CORNING OPTICAL DROP CABLE, 60M

CORNING OPTICAL DROP CABLE, 80M

CORNING OPTICAL DROP CABLE, 120M

CORNING OPTICAL DROP CABLE, 200M

Aerial

Universal Drop cable, 20M, SMF RBR, Optitap-SC/APC

Universal Drop cable, 40M, SMF RBR, Optitap-SC/APC

Universal Drop cable,75M, SMF RBR, Optitap-SC/APC

Universal Drop cable, 100M, SMF RBR, Optitap-SC/APC

Universal Drop cable, 150M, SMF RBR, Optitap-SC/APC

Replacement blades for Universal Drop cable stripper tool

NTU INSTALLATION CHECKLIST

TOW#

Date
Labor

Fibre tail from PCD to location on external
wall entry

Hole through wall and seal. 21

Internal patch cord from internal wall to
NTD

Price to fix NTD on the internal wall

Install 12v power cable to NTD

Install PSU to wall (Internal)

Patch FDH

Activate and test NTD

Customer Education

Other

Initial survey of property

Multiport

FDH

Light testing

Terminating fibre

Completing paperwork.

Battery Backup

Battery Back-up Internal

Demand Drop

Aerial Drop

Underground - New Conduit

Trenching Time

Conduit Pull Through

Underground - Existing Conduit

Internal NTD

Realflex 3 drop cable single fibre SC/APC
IVORY

Cat 6. Solid Core UTP Network Cable
(Tether cable)

SCA-SCA Splx 9/125 Patch 2Mtr (Patch
cord ONT to wall plate)

Clipsal indoor 6-gang wallplate

Clipsal RJ11 Telephone Keystone Jack

Clipsal Cat6 Keystone Jack

Indoor wall outlet SC/APC

Fibre Connectors

NO POLISH SC/APC CONNECTOR SM
FLAT SPLICE 250/900 8800-APC/FS

Battery Backup

DC cable for O_UPS (Battery Backup)

Fibre

Pictures

PCD Location, PCD terminated, MPT labelled, NTU terminated, meter readings, pictures to support extras.
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.