UFF - Utility Pole Attachment - V2.7

• UFF Service Order Number (Not AWMS Number)

• Street address of the premises to be provisioned:
  Address

• Date of Request

  Date

• Business or Residential

• FDH Number

• Purpose of Pole Usage into the premises (short description)

  

• Purpose of Pole Usage into the premises (short description)

  Option A Overhead to Overhead

  Option B Overhead to Underground

  Option C Underground to Overhead

  Option D Overhead to Overhead\Underground

• Pole Element

Pole
• Street Address of the Pole. (to include city/town name and/or GPS coordinates.
  Address

Visual Inspection

• Utility pole owner

  Select Powerco Chorus WEL Networks Waipa Networks Private Service Pole Unknown

  • Powerco
  • Chorus
  • WEL Networks
  • Waipa Networks
  • Private Service Pole
  • Unknown

• Pole Asset Number

• Pole Type

  Softwood

  Concrete

  Hardwood

  Other

• Pole Type if Other

• Pole Height

• Pole Diameter (if applicable)

• Asset Owner Pole Tag\Colour (if applicable)

• Visual Pole Condition

  Good

  Average

  Poor

• Ground Restraint

  Concrete

  Grass

  Tarseal

  Other

• Special Purpose Pole ( Is it a stub pole, brace pole, pole with jockey arms)

  Yes

  No

  N/A

• Select from range

• If yes please specify

• Take photo of the complete pole.

  Media

• Is The Pole Located Inside The Boundary on a ROW, Shared Driveway, Long Drive or any Private Land?

  Yes

  No

  N/A

• If yes please specify

• Take photo of the pole location if not already captured previously.

  Media

• Is the Pole Supporting Street Lighting or Spans Longer than 100m? (Typical span length is around 60m in the urban environment)

  Yes

  No

  N/A

• If yes please specify

• Take a photo of the entire pole if not already captured previously.

  Media

• On the UFF aerial installation route ("towards the premises"), are there any Service Drop Leads CURRENTLY present (to include Chorus SDL and UFF SDL)

  Yes

  No

  N/A

• If yes please specify the amounts and services.

• Take a photo of the entire pole with enough detail to show the Aerial Cable Attached.

  Media

• 

• Does the Pole have electrical Service Leads Attached?

  Yes

  No

  N/A

• If yes please specify.

• Add media

  Media

• Does any point of the cable route encroach into aerial trespass.

  Yes

  No

  N/A

• Brief Synopsis of the issue.

• Photo of the issue if not already captured.

  Media

• Can service separation be maintained?

  Yes

  No

  N/A

• Brief synopsis of the issue.

• Photo of the issue if not already captured previously.

  Media

• 

• Can ground clearance be maintained.

  Yes

  No

  N/A

• Brief synopsis of the issue.

• Photo of the issue if not already captured previously.

  Media

• How many Service Drop Leads in total on the pole (all services excluding power)

• Connection type i.e. Service Drop Lead, network distribution/ network build.

• List UFF material attached to the pole (e.g. riser duct, aerial FAT) to include enclosure ID applicable.

• Additional remarks and photograph of anything else relevant that has not already captured.

  Media

• Screenshot of the lay plans if available.

  Media

• Photograph the pole (wide view and significant features) if not already captured.

  Media

• Overlay the fibre pathway onto a photograph showing the route.

  Media

Pole Testing

• 

• Is the pole red tagged?

  Yes

  No

  N/A

• Take photo of the tag number and note the pole number and address.

  Media

• DO NOT USE THIS POLE IF RED TAGGED

• Is the proposed installation to be installed inside the telecommunications plane .

  Yes

  No

  N/A

• If yes, does the technician have the asset owner's competencies.

  Yes

  No

  N/A

• If yes do not carry out any work unless suitably qualified and competent.

• Is any of the work to be carried out in the power plane

  Yes

  No

  N/A

• If yes, the minimum qualification is Line Mechanic.

  Acknowledged

• If yes do not carry out any work on this asset unless suitably qualified and network induction has taken place.

• Has the Line Mechanic been inducted onto the network by the asset owner.

  Yes

  No

  N/A

• Hammer and probe Test completed?.

  Yes

  No

  N/A

• If no, do not carry out any work on this asset.

• Take a photo of the pole Test at the base of the pole, 300mm of excavated soil. For poles placed in tar seal take a photo of the pole base and surrounding area.

  Media

• Are there any, or do you suspect any safety concerns from other services (e.g.Power, Chorus) not associated with the pole structural integrity.

  Yes

  No

• Does your concern stop any further usage of this pole. Even if clarity on the issue is sought.

  Yes

  No

• 

• Pole Test Pass or Fail ( taking into account the structural integrity and other H & S concerns)

  Pole Passes Pole Test

  Pole Fails Pole Test (DO NOT CLIMB)

• 

UltraFast Fibre

• UFF Contractor Signature

  Sign

Asset Owner Approval

• Asset Owner Approval Required.

• Asset Owner Approval Signature