THI KIM VAN LE / SILCAR / NBN

• 
  Thi Kim Van Le Silcar Communications
  275 Blunder Rd 1/60 Enterprise Pl
  Durack QLD 4077 Tingalpa, Qld. 4173
  ABN: 56 164 164 710 ABN: 56 598 384 882

• Document No.

• ToW#

• Date

  Date
• Location
  Address

Section 1 - Work Order Details

• TOW#

• Date

  Date
• Work Site
  Address

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

• First Aider Name & Phone No: Brandon Phan-Nguyen 0466992308

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

• 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.

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

• Installations in Customer Premises NAT SCSWMS- 081

• Mechanical Fibre Splicing NAT SCSWMS- 088

• Other

High Consequence Hazards

• Site Supervisor’s Notes - please ensure the appropriate checklist is completed if any of the high consequence hazards below are applicable
  

• 1. Working near underground assets<br>(energised electrical installations, near<br>pressurised gas)

  Yes

  No

  N/A

• 2. Working near Powerlines (LV/HV)

  Yes

  No

  N/A

• 3. Working in a Confined Space

  Yes

  No

  N/A

• 4. Working near powered mobile plant

  Yes

  No

  N/A

• 5. Working on or adjacent to a road

  Yes

  No

  N/A

• 6. Working near or adjacent to EME zones

  Yes

  No

  N/A

• 7. Risk of falling more than 2 metres – refer<br>to the EWP RA

  Yes

  No

  N/A

• 8. Working with Asbestos

  Yes

  No

  N/A

• 9. Working on Telecommunications Towers

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• 11. Working on or adjacent to a railway

  Yes

  No

  N/A

• 12. Working near water or other liquids<br>where there is a risk of drowning

  Yes

  No

  N/A

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).

Inductee

• Add signature

  Sign

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

  Sign

• 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.

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

  Date
• Location
  Address

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

  Sign

• Organisation

• Purpose of Visit

• Inducted By (Site Supervisor Signature)

  Sign

Demand Drop External build TOW Form

• TOW#

• Site Address
  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

  Sign

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#

• Date

  Date
• Site Address
  Address

• Contact Name & Number

• Time Attended Site

  Date

• Time Left Site

  Date

• NTD Serial:

• PSU Serial:

• Test Results

• Service Activation Reference #

• Battery Back-up

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Can you proceed to complete this job<br>safely?

  Yes

  No

  N/A

• Non Standard Install Quote

  Yes

  No

  N/A

• Way Leave Consent

  Yes

  No

  N/A

• Spares Form

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• I have received the NBN User Guide and<br>Battery Backup Guide

  Yes

  No

  N/A

• Signature

  Sign

Aerial/Underground Drop Cable As-Built

• TOW#

• Draw Lead in Plan

  Drawing

• Comments

• 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

• 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

• TOW#

• Date

  Date

Labor

• Fibre tail from PCD to location on external<br>wall entry

  Yes

  No

  N/A

• Hole through wall and seal. 21

  Yes

  No

  N/A

• Internal patch cord from internal wall to<br>NTD

  Yes

  No

  N/A

• Price to fix NTD on the internal wall

  Yes

  No

  N/A

• Install 12v power cable to NTD

  Yes

  No

  N/A

• Install PSU to wall (Internal)

  Yes

  No

  N/A

• Patch FDH

  Yes

  No

  N/A

• Activate and test NTD

  Yes

  No

  N/A

• Customer Education

  Yes

  No

  N/A

Other

• Initial survey of property

  Yes

  No

  N/A

• Multiport

  Yes

  No

  N/A

• FDH

  Yes

  No

  N/A

• Light testing

  Yes

  No

  N/A

• Terminating fibre

  Yes

  No

  N/A

• Completing paperwork.

  Yes

  No

  N/A

Battery Backup

• Battery Back-up Internal

  Yes

  No

  N/A

Demand Drop

• Aerial Drop

  Yes

  No

  N/A

• Underground - New Conduit

  Yes

  No

  N/A

• Trenching Time

  Yes

  No

  N/A

• Conduit Pull Through

  Yes

  No

  N/A

• Underground - Existing Conduit

  Yes

  No

  N/A

Internal NTD

• Realflex 3 drop cable single fibre SC/APC<br>IVORY

  Yes

  No

  N/A

• Cat 6. Solid Core UTP Network Cable<br>(Tether cable)

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Clipsal indoor 6-gang wallplate

  Yes

  No

  N/A

• Clipsal RJ11 Telephone Keystone Jack

  Yes

  No

  N/A

• Clipsal Cat6 Keystone Jack

  Yes

  No

  N/A

• Indoor wall outlet SC/APC

  Yes

  No

  N/A

Fibre Connectors

• NO POLISH SC/APC CONNECTOR SM<br>FLAT SPLICE 250/900 8800-APC/FS

  Yes

  No

  N/A

Battery Backup

• DC cable for O_UPS (Battery Backup)

  Yes

  No

  N/A

Fibre

• PCD Location, PCD terminated, MPT labelled, NTU terminated, meter readings, pictures to support extras.

  Media