Title Page

  • Conducted on

  • Prepared by

  • Location
  • Select date

  • Asset Location

Pole Information

  • Type of Pole

  • POLE ID

  • Condition of pole

  • Pole safety signage present

  • Picture of pole

  • Detailed pictures of damage if present (Conditions of: Conductor, Cross arms, Insulators, Turn Buckles)

  • GPS Coordinates of pole

Vegetation Management

  • Are there any trees and or tree limbs that pose a threat to the transmission line ?

  • Pictures of trees and tree limbs that are encroaching the transmission lines

  • GPS Coordinates of trees and limbs that are encroaching the transmission lines.

  • Add location
  • Are there any shrubs and or bushes under transmission line splice points or around the poles ?

  • Pictures of shrubs and bushes under the transmission line splice points and around the poles.

  • GPS Coordinates of shrubs and bushes under the transmission line splice points and around the poles.

  • Add location
  • Completed By

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.