Information

  • S/O number

  • Address

  • Customer service area

  • Auditee

  • Company name

  • Prepared by

  • Conducted on

  • Document No.

4 Codes

  • 4.004 Correct Statement of Work codes used

6 Work Areas & Safety

  • 6.001 Personal and site safety procedures observed

  • 6.002 Hazards identified & recorded - worksite audit form completed / hazard notices in place

  • 6.003 Transit TMP provided

  • 6.004 Services located

  • 6.005 Power and Gas clearances correct

25 Poles

  • 25.003 Pole in good condition, no splits, burs

  • 25.010 Pole safe to climb ( hammer/probe/dig)

  • 25.012 Plant positioned correctly and safety, plant clearances correct

  • 25.014 Unsafe poles labelled / marked for replacement / 7 days

  • 25.015 Unsafe poles noted in hazardous pole register

38 UFB Fibre Flexibility Point (FFP)

  • 38.001 Outer Door lock works smoothly and door closes without jamming (minex)

  • 38.002 Door stays are in place and all work well (minex)

  • 38.004 Distribution Frame: Correct Trays installed and labeled (minex)

  • 38.005 Distribution Frame: Drawer Labelling correct (minex)

  • 38.006 Distribution Frame: Data card inside of drawer

  • 38.010 All duct seals in place for cable entry (minex)

  • 38.012 Locks & hinges OK (minex)

  • 38.013 Door seals in good condition (minex)

  • 38.017 All unused connectors capped

  • 38.018 Splitter leg parking bay (minex)

  • 38.019 All micro ducts sealed (minex)

  • 38.020 All micro ducts labelled (minex)

  • 38.027 managed via mandrels / Velcro ties used

  • 38.028 Two fibres per customer rule observed within individual tray

  • 38.029 No fibre or task waste , all optical (glass) ends safely contained

  • 38.030 Data card completed in pencil - micro duct # , splitter and splitter leg # , address , distance to customers address

  • 38.033 Allocated tube used - EPFU routed correctly, from allocated tube, over mandrel to correct tray position

  • 38.034 EPFU - secured via strain relief bung or approved over sleeve - NIL connectors or unapproved tube extensions

  • 38.035 Allocated splitter leg identified and routed over mandrel into correct tray position

  • 38.036 FIP both LC connectors prior to connection

  • 38.037 Connect,verify minimum bend radius is maintained when drawers are opened or closed

  • 38.038 ABF - Connection position, start at bottom tray up, from back to front in sequence

39 Aerial Terminal

  • 39.004 Terminal lid secure

  • 39.005 Terminal label on lid or plate on pole

  • 39.006 Lead-in entry correct

41 BDD Terminal

  • 41.001 Pit lids secure/locked, with bung fitted where appropriate

42 PDS Terminal

  • 42.002 Correct size pedestal used

  • 42.003 Lid secure

  • 42.004 PDS network labelled correctly

  • 42.008 Foam bung fitted

  • 42.015 Micro duct sheath opening 50mm above bung

  • 42.019 Plastic bags secure, separate bag for loop / cable end and underground leads ( minex)

  • 42.020 Has best endeavours been undertaken to bring copper up to MINEX standard (minex)

  • 42.023 Network labelling in place to suit requirements (minex)

  • 42.024 Pedestal straight and secure

43 Aerial Service Lead

  • 43.001 Correct Service Lead used

  • 43.002 No In span joints

  • 43.003 Tension, sag and twist correct

  • 43.004 Correct pole fittings used and installed (screw eyes, sash clamps)

  • 43.006 White pipe down poles

  • 43.007 600mm saddle spacing or 1500mm bandit spacing

  • 43.008 Roadway crossing min 5.5m height, elsewhere 4.25 metre height

  • 43.012 Correct building fittings used (screw eyes, sash clamps)

  • 43.016 Aerial lead managed on pole from termination to termination

44 Buried Service Lead

  • 44.001 Service Lead terminated correctly

  • 44.002 20mm pipe connected at Pedestal correctly - (bend into pedestal)

  • 44.003 20mm pipe connected at BDD correctly (50mm into BDD pit, 450mm deep)

  • 44.007 Green 20mm installed in trench

  • 44.008 White pipe above ground level

  • 44.009 Depth correct (350mm cover)

  • 44.017 Both ends of the ribbonet correctly sealed during the lead in process

45 ETP

  • 45.001 ETP physical alignment correct, all fittings secure, installation tidy

  • 45.005 20mm pipe to ETP is white only

  • 45.017 Ericsson 5/NEG203200 FTP installed

  • 45.018 ETP installed (level) between 300mm and 1500mm above ground, secure with 3 screws, and installed to best suit the site and external cladding

  • 45.021White pipe or flexi duct fitted to outside of building secured with plastic or galvanised saddles

  • 45.022 50-20mm duct reducer fitted between 50mm underground greed duct and 20mm above ground white pipe

  • 45.023 Fixed fibre or ABF tube housed in 20mm white pipe or UV stabilised flexi pipe where fibre exits through bottom of ETP

  • 45.023 Correctly connected to hybrid cable

  • 45.025 Locate element correctly managed

  • 45.026 30mm bending radius unconditionally observed at all locations

  • 45.027 Fibre splicing within design tolerance

  • 45.028 Heat shrink splice protectors secured from movement

  • 45.029 Fiber continuity confirmed

  • 45.030 No fibre or task waste, all optical (glass) ends safely contained

  • 45.031 Gas block connector installed on the micro duct

  • 45.032 Sufficient length of metallic braid tape prepared and left for future locate purposes

  • 45.033 DB - green sheath open 20mm above ETP entry position - black sheath 25mm above the green - earth strap installed and secured in position

  • 45.034 Micro duct held in position with zip tie

  • 45.035 Laser label positioned externally on the lid - supplied screw installed in bottom of ETP

  • 45.036 Cable entry to building sealed

  • 45.037 Unused copper pairs are capped with clearing connectors

  • 45.038 Hybrid cable / pigtail enters ETP at the correct position. Bend guide in position

  • 45.039 Fibre managed correctly, length not excessive causing unnecessary bends

  • 45.040 Min 5mm hybrid cable sheath inside ETP

46 Customer Premises

  • 46.001 Correct cable used (cat 5 minimum - star wiring)

  • 46.003 Correct clearances observed

  • 46.004 Wiring route acceptable and cable safe and secure

  • 46.006 Exposed surface wiring neat and tidy

  • 46.007 Jack point hardware installed correctly

  • 46.008 Jack points not installed in damp areas

  • 46.009 Jack points at least 300mm above floor

  • 46.014 Contractor appearance/manner (customer view)

  • 46.016 Optical power meter test at the ONT prior to plugging in the SC/A connector

  • 46.017 Fiber/Copper hybrid cable used

  • 46.018 No fibre or task waste, all optical (glass) ends safety contained

  • 46.019 Connectors cleaned and verified with fibre inspection probe

  • 46.020 ONT/RGW installed and secured correctly 300mm above the floor

  • 46.021 ONT/RGW not installed in a damp area

  • 46.022 Flexi pipe used under the floor or in the ceiling spaces to protect the fibre and is secured to the building

  • 46.023 Internal cabling secure including pigtail from ONT to RGW

47 Business Premises

  • 47.006 Connectors cleaned and verified with fibre inspection probe

  • 47.007 No fibre or task waste, all optical (glass) ends safely contained

49 Sales & Service Advice Note

  • 49.001 Completion time and date filled in

  • 49.002 Service Order number correct

  • 49.003 Customer details correct

  • 49.004 Service Required Details correct

  • 49.005 Additional services provided are clearly recorded

  • 49.006 Customer acknowedged with name and signature (or reason for no customer signature included)

  • 49.007 S/O type correct

  • 49.009 Service person name

  • 49.01 Correct Billing Codes claimed

  • 49.011 Phone / Circuit number correct

  • 49.012 CSA correct

  • 49.013 Network elements where work was carried out

  • 49.015 Location service confirmed at

65 FFP cabinet external

  • 65.007 Cabinet identification label on front door top LHS (minex)

  • 65.008 Graffiti notice in place below cabinet ID (minex)

67 Customer OFDF

  • 67.001 OFDF in a CNSP approved enclosure, net map label on OFDF lid

  • 67.002 Fibre managed within OFDF ok

  • 67.004 30mm bending radius unconditionally observed at all locations

  • 67.005 Protective caps on all unterminated connectors

  • 67.006 Connectors cleaned and verified with fibre inspection probe

  • 67.007 Laser safety labels (1M Safety) at OFDF (inside and front panel)

  • 67.008 Fibre cable entry to building sealed and managed to OFDF ok

  • 67.009 Flexi pipe protects fibre under the floor or in the ceiling spaces and is secured to the building

  • 67.010 LSZH fibre used

  • 67.011 No fibre or task waste, all optical (glass) ends safely contained

  • 67.014 Optical power meter test at the ONT prior to plugging in the SC/A connector

68 Fibre Access Terminal

  • 68.001 Entry tubes sealed

  • 68.002 Two fibres per tray only

  • 68.003 Lead cleaned and abraded

  • 68.004 Rayblocks fitted to tubes (90mm) and shrunk down to deal cable into the access tube (glue extruding)

  • 68.005 Tube holder installed

  • 68.007 Silica gel pack installed/replaced

  • 68.008 Triangle symbols on dome and base match

  • 68.009 All latches are closed

  • 68.010 O-ring installed

  • 68.011 Fibre routed

  • 68.013 Slack managed in fibre management coil

  • 68.014 Swing arm and bracket in working order / or mounted on manufactured bracket (minex)

  • 68.015 Lid locked and lock bung installed

  • 68.016 30mm bending radius unconditionally observed at all locations

  • 68.018 Heat shrink splice protectors secure from movement

  • 68.019 No fibre or task waste, all optical (glass) ends safely contained

  • 68.025 Laser label positioned externally on the lid (minex)

  • 68.026 Tray labelled with cabinet fibres, customers address and splitter leg #

69 Blown Fibre boundary connection

  • 69.001 1-Way tubes trimmed accurately and securely seated in 5mm connector

  • 69.002 1 Way ribbonet connector secure

  • 69.003 Cover board installed prior to reinstatement

72 Reinstatement

  • 72.001 Property damage made good

  • 72.002 Ground reinstatement completed around poles

  • 72.003 Reinstatement / backfill satisfactory around buried service lead

  • 72.007 Excess vegetation removed

  • 72.008 Reinstatement complete around pedestal

  • 72.009 Reinstatement complete around hand hole

73 Site tide

  • 73.001 Site tidy, no task waste - poles

  • 73.002 Site tidy, no task waste - cabinet internal

  • 73.005 Site tidy, no task waste - BDD terminal

  • 73.006 Site tidy, no task waste - PDS terminal

  • 73.007 Site tidy, no task waste - Aerial service lead

  • 73.008 Site tidy, no task waste - buried service lead

  • 73.009 Site tidy, no task waste - ETP

  • 73.010 Site tidy, no task waste - customers premises

  • 73.011 Site tidy, no task waste - Business premises

  • 73.013 Site tidy, no task waste - hand holes

  • 73.015 Site tidy, no task waste - GLC

  • 73.016 Site tidy, no task waste - channel pit

74 Hand Holes

  • 74.001 Bedding down correctly and compacted

  • 74.002 Lock facing the customer boundary and openable

  • 74.006 Lateral labelled

  • 74.007 Hand holes locked

75 Ground Level Closures

  • 75.001 Vertical, firm (minex)

  • 75.002 Lid secure, padlock in place

  • 75.004 Micro ducts labelled

  • 75.006 Micro ducts capped (minex)

  • 75.015 All micro ducts secured into management brackets

  • 75.019 30mm bending radius unconditionally observed at all locations

  • 75.021 Laser label positioned externally on lid

  • 75.022 EPFU routed correctly to tray

  • 75.023 Fibre splice secured in tray holder

  • 75.024 EPFU from port 2 routed around organiser to tray secure with Velcro

  • 75.025 Tray labelled with EPFU, address and distance to customers site

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.