Title Page

  • UFF Service Order Number (Not AWMS Number)

  • Street address of the premises to be provisioned:
  • Date of Request

  • Business or Residential

  • FDH Number

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

    no label
  • Purpose of Pole Usage into the premises (short description)

  • Pole Element

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

Visual Inspection

  • Utility pole owner

  • Pole Asset Number

  • Pole Type

  • Pole Type if Other

  • Pole Height

  • Pole Diameter (if applicable)

  • Asset Owner Pole Tag\Colour (if applicable)

  • Visual Pole Condition

  • Ground Restraint

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

  • Select from range

  • If yes please specify

  • Take photo of the complete pole.

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

  • If yes please specify

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

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

  • If yes please specify

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

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

  • If yes please specify the amounts and services.

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

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  • Does the Pole have electrical Service Leads Attached?

  • If yes please specify.

  • Add media

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

  • Brief Synopsis of the issue.

  • Photo of the issue if not already captured.

  • Can service separation be maintained?

  • Brief synopsis of the issue.

  • Photo of the issue if not already captured previously.

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  • Can ground clearance be maintained.

  • Brief synopsis of the issue.

  • Photo of the issue if not already captured previously.

  • 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.

  • Screenshot of the lay plans if available.

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

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

Pole Testing

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  • Is the pole red tagged?

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

  • DO NOT USE THIS POLE IF RED TAGGED

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

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

  • 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

  • If yes, the minimum qualification is Line Mechanic.

  • 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.

  • Hammer and probe Test completed?.

  • 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.

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

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

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

  • no label

UltraFast Fibre

  • UFF Contractor Signature

Asset Owner Approval

  • Asset Owner Approval Required.

  • Asset Owner Approval Signature

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