Information

  • Enter the last 7 digits of the TOW number ( eg 2084431)

  • Time and date of the audit.

  • Prepared by (your full name)

  • Your contact number

  • Company Name

  • What is the End Users Address ?

  • Please select your CSA - NSW

  • Please select your CSA - ACT

  • Please select your CSA - QLD

LIC and Audit Data

LIC DATA ( Required for all PreScope pass audits)

  • If this is a PreScope pass, please ensure the LIC data is captured on this form. If it is a PreScope fail you will need to capture the LIC data on the Thiess new SOR form when the remediation work is completed.

  • Is there a LIC present ?

  • Enter the approx length from the Multiport to the PCD location

  • Select from range

  • If YES what is the LIC material ?

  • If YES what is the LIC diameter ?

  • If NO please provide the planned remediation or the reason why in the sections below.

  • Was the Telstra LIC used?

  • If the Telstra LIC is NOT going to be used please select the reason from the list.

PRESCOPE PASS OR FAIL DETAILS

  • 2. Pre scope PASS or FAIL details. Please ensure you take all the supporting photos needed depending on the status of the audit. If you remediate on the same day as the audit please ensure you also complete the Thiess new SOR form and submit both the PreScope and SOR form data to the required email addresses within 24 hours of completion.

  • DOES THE PRESCOPE AUDIT PASS OR FAIL ?

PRESCOPE PASS ( Please select an item below )

  • PreScope pass - rod and roped

  • PreScope pass - lead in cable installed

  • PreScope pass - customer already connected

  • PreScope pass - blockage repaired

  • Enter the amount of blockages

  • Please ensure you take supporting photos of the blockage and of the remediation works once completed.

  • Please add any commentary necessary to validate these claims.

PRESCOPE FAIL ( Please select an item below )

  • PreScope fail - unable to locate multi port

  • Pre Scope fail - Pit upgrade required

  • PreScope fail - multi port full

  • PreScope fail - end user not at home

  • PreScope fail - back yard feed

  • PreScope fail - unable to locate lic at premises (lic enters cavity wall)

  • PreScope fail - asbestos pit break out required

  • PreScope fail - asbestos pit new pit required

  • PreScope fail - OH&S reasons

  • PreScope fail - lic blocked or network blockage

  • PreScope fail - network remediation required

  • PreScope fail - no existing LIC as the current network is aerial

  • PreScope fail - NBN pole licence issue

  • Enter the pole number associated with this location.

SUGGESTED MACHINERY OR INSTALLATION METHODS REQUIRED

  • 3. Please indicate the preferred method of remediation and the suggested machinery required.

  • Excavator required

  • Enter dig meterage required

  • Take some supporting photos.

  • Trencher required

  • Enter the dig meterage required

  • Take some supporting photos.

  • Hand Dig ( shovel and pick ) required

  • Enter the dig meterage required

  • Take some supporting photos.

  • Grundomat ( Under Bore ) Required

  • Enter meterage for bore 1

  • Enter meterage for bore 2

  • Enter meterage for bore 3

  • Take some supporting photos.

  • Concrete Cut / Reinstatement Required

  • Enter the cutting meterage required

  • Take some supporting photos.

  • Core Bore per 100mm Required

  • How many core bores are required

  • Take some supporting photos.

PRESCOPE FAIL SUPPORTING ITEMS

  • 4. PreScope fail supporting items. Please include as many images as possible validating the reason the PreScope audit failed.

  • Enter some details that outline what the remediation work will entail.

  • Please provide a mud map of the location outlining MPT location, length and location of the LIC, location of any blockages etc.

  • Image 1 capture the whole area

  • Image 2 zoom in for a close up

  • Image 3

  • Image 4

PLANNED REMEDIATION DATE ( PRD )

  • 5. PRD date ( planned remediation date ) When will the LIC be installed/repaired ?

  • Please enter the PRD for this location. If the PRD is going to be past the currently scheduled activation date please provide the reason why below.

  • Please give as much detail as possible outlining why the PRD needs to be extended.

Audit Closure

PreScope Audit Closure

  • The following are important Business Rules relating to the trust and verify documentation needed for Project PreScope and Project 750.

    - All completed form data MUST be sent to the email addresses listed below within 24 hours of completion.
    - LIC data MUST be provided on all PreScope PASS forms.
    - If the audit is a PreScope FAIL the LIC data MUST be provided on the Thiess new SOR form submission.
    - If you remediate on the day of the PreScope audit you MUST provide both the PreScope and Thiess new SOR form data to the email addresses listed below within 24 hours.
    - The subject for the email MUST be sent using the outline in the sample (TOW 00012345) 123 Smith Street Sydney NSW).Please do not add anything more or less in the subject line.
    - Please ensure you are exporting this form data in the CSV format required.
    - If you have any questions or queries please refer to your user guide and email updates.

    PreScope PASS email - fsdprescopepass@thiess.com.au
    PreScope FAIL email - fsdprescopefail@thiess.com.au

    Please refer to your user guide or email updates for the email address to send the Thiess new SOR form data to as these are state specific.

  • By signing below I agree I have assessed this location to the best of my ability and have collected all the required trust and verify data needed to satisfy all of the Business Rules.

  • PreScope Auditor Name and Signature

  • Date

End User Acceptance

  • By selecting the check box and/or signing my name I agree to the proposed PCD and NTD locations as outlined by the auditor today. I also understand that these may need to change on the day of installation due to design or construction requirements that can only be identified at the time of installation. I also agree that I have discussed the requirements relating to any proposed civil works needed to have my service installed and I hereby give approval for these proposed works to proceed. I am aware that these requirements may change at any time and I will discuss any proposed changes with the team members that attend to complete my installation on the scheduled date. Lastly I also confirm that I have permission to make these agreements and have done so of my own free will.

  • End user Signature

  • End User Name

  • Select Date

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.