Title Page

  • Conducted on

  • Prepared by

  • Location
  • TOW NUMBER:

  • NODE DA:

  • ADDRESS OF NODE:

  • SURVEYED BY:

  • CONTACT NUMBER:

  • HAVE YOU ON-SITED:

  • TIME ON-SITED:

  • PERSONS NAME WHO ON-SITED YOU:

  • ADDRESS YOU ARE CURRENTLY TESTING AT:

  • CONFIRM "O" PAIRS AT PILLAR:

  • CONFIRM "C" PAIRS AT PILLAR:

  • CONFIRM "O" PAIR RANGE:

  • Pillar

PILLAR INSPECTION:

  • WHAT IS THE ADDRESS WHERE YOU ARE TESTING FROM?

  • DOES THE PILLAR REQUIRE ANY WORK:

  • RE-SOLDERING:

  • QUANTE MODULE REPLACEMENT:

  • "O" PAIR RANGE:

  • COMMENTS & SOR’s

  • ATTACH PHOTO’s HERE:

RUN SPEED TEST FROM LEAD-IN JOINT OUTSIDE CUSTOMERS HOUSE:

  • ACTUAL RATE UPLOAD/DOWNLOAD:

  • MAX RATE UPLOAD/DOWNLOAD:

  • ATTACH PHOTO's HERE:

RUN VOLTAGE TESTS:

  • A-B:

  • A-E:

  • B-E:

  • ATTACH PHOTO's HERE:

RUN RESISTANCE TEST:

  • A-B:

  • A-E:

  • B-E:

  • ATTACH PHOTO's HERE:

RUN CAPACITANCE TEST:

  • A-B:

  • A-E:

  • B-E:

  • ATTACH PHOTO's HERE:

RUN TDR TEST:

  • ATTACH PHOTO HERE:

  • PIT TYPE:

  • PIT SIZE:

  • LID STATUS:

  • JOINT TYPE:

  • JOINT REPLACEMENT REASON:

  • ATTACH PHOTO's HERE:

  • SIZE OF JOINT:

  • IS THERE ENOUGH CABLE LENGTH TO RE-MAKE JOINT:

  • DOES THE CABLE NEED TO BE REPLACED:

  • IS THE CABLE DIRECT BURIED:

  • DOES THE CABLE MOVE IN THE PIPE:

  • LENGTH OF CABLE THAT NEEDS TO BE REPLACED:

  • ATTACH PHOTO's

  • CABLE GAUGE:

  • IS THERE CIVIL WORK REQUIRED:

  • DESCRIPTION OF CIVILS WORK REQUIRED AND SUPPLY ALL SOR's TO COMPLETE:

  • ATTACH PHOTO's

  • ATTACH ATLAS MUD MAP HERE:

  • HAVE YOU ATTACHED ATLAS MUD MAP:

  • HAVE YOU RE-CONNECTED THE JUMPER AT PILLAR:

  • HAVE YOU OFF-SITED:

  • WHAT TIME DID YOU OFF-SITE:

  • WHO DID YOU OFF-SITE WITH:

  • TECHNICIAN'S SIGNATURE

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