Title Page
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Conducted on
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Prepared by
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Location
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TOW NUMBER:
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NODE DA:
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ADDRESS OF NODE:
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SURVEYED BY:
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CONTACT NUMBER:
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HAVE YOU ON-SITED:
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TIME ON-SITED:
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PERSONS NAME WHO ON-SITED YOU:
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ADDRESS YOU ARE CURRENTLY TESTING AT:
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CONFIRM "O" PAIRS AT PILLAR:
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CONFIRM "C" PAIRS AT PILLAR:
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CONFIRM "O" PAIR RANGE:
Pillar
PILLAR INSPECTION:
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WHAT IS THE ADDRESS WHERE YOU ARE TESTING FROM?
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DOES THE PILLAR REQUIRE ANY WORK:
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RE-SOLDERING:
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QUANTE MODULE REPLACEMENT:
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"O" PAIR RANGE:
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COMMENTS & SOR’s
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ATTACH PHOTO’s HERE:
RUN SPEED TEST FROM LEAD-IN JOINT OUTSIDE CUSTOMERS HOUSE:
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ACTUAL RATE UPLOAD/DOWNLOAD:
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MAX RATE UPLOAD/DOWNLOAD:
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ATTACH PHOTO's HERE:
RUN VOLTAGE TESTS:
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A-B:
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A-E:
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B-E:
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ATTACH PHOTO's HERE:
RUN RESISTANCE TEST:
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A-B:
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A-E:
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B-E:
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ATTACH PHOTO's HERE:
RUN CAPACITANCE TEST:
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A-B:
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A-E:
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B-E:
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ATTACH PHOTO's HERE:
RUN TDR TEST:
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ATTACH PHOTO HERE:
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PIT TYPE:
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PIT SIZE:
- P1
- P2
- P3
- P4
- P5
- P6
- P7
- P8
- P9
- A
- B
- C
- D
- M/H 9
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LID STATUS:
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JOINT TYPE:
- PVC
- SHSOJ
- LHSOJ
- XAGA LEAD
- XAGA PVC
- RADI
- SAM
- PEDI CAP
- EJ
- DEXGREEN
- OTHER
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JOINT REPLACEMENT REASON:
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ATTACH PHOTO's HERE:
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SIZE OF JOINT:
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IS THERE ENOUGH CABLE LENGTH TO RE-MAKE JOINT:
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DOES THE CABLE NEED TO BE REPLACED:
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IS THE CABLE DIRECT BURIED:
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DOES THE CABLE MOVE IN THE PIPE:
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LENGTH OF CABLE THAT NEEDS TO BE REPLACED:
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ATTACH PHOTO's
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CABLE GAUGE:
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IS THERE CIVIL WORK REQUIRED:
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DESCRIPTION OF CIVILS WORK REQUIRED AND SUPPLY ALL SOR's TO COMPLETE:
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ATTACH PHOTO's
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ATTACH ATLAS MUD MAP HERE:
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HAVE YOU ATTACHED ATLAS MUD MAP:
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HAVE YOU RE-CONNECTED THE JUMPER AT PILLAR:
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HAVE YOU OFF-SITED:
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WHAT TIME DID YOU OFF-SITE:
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WHO DID YOU OFF-SITE WITH:
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TECHNICIAN'S SIGNATURE