• Conducted on

  • S/O Number

  • Address

  • LX Commit Date

  • Prepared by:

  • Estimated time to complete technical install

Next Actions

  • HighCost Needed.

  • What work type is to be completed?

  • Chorus approval required

  • CPE code Claim

  • Awaiting a Car

  • Is the RGW on site?

  • Is the Customer happy with the Istall date?

  • 2 Day Install

  • Type of network?

  • Specific skills required?

  • What Skill set required?

  • Distance of drill shot? Note: If less than 20m a grundomat can be used.

  • Distance of trenching?

  • Short description of other

  • Short description of what is required

Customer / Job Details

  • Name

  • Contact

Job instructions

  • Detailed description of works required

  • Add labelled photos using the 'inote HD' app

Health, Safety and Environmental Issues

  • Underfloor access?

  • Ceiling access?

  • Location of ETP?

  • Gas detector required?

  • Dogs on site?

Consents Required

  • Right of way?

  • Multi dwelling unit?

  • Heritage site or Building?


  • 3rd Party pole. Number, Location, Termination Type.

  • Distance from boundary to ETP?

Internal information

  • WYAH materials?

  • Preferred location of ONT?

  • Preferred location of RGW?

Additional notes

  • Notes

Outside property consent

  • Hole excavation and trenching?

  • Removal of concrete/tiling/pavement?

  • Installation of conduit(s)?

  • Removal of existing copper line to the house?

  • Others? E.G. Heath & Safety, Needs a CAR.

  • Clean up: We will leave the property in a clean and tidy state on competition. This does not include reinstatement to the same condition.

Inside property consent

  • Drilling small holes?

  • Cutting holes in walls?

  • Exposed surface wiring?

  • Removal of ceiling tiles?

  • Surface mounted installation and hardware?

  • Others?

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.