• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Add team member names here


  • GI Site left tidy on completion of works

  • G2 Pole planted straight and to correct depth

  • G3 Re-instatement of any holes good and excess soil removed

  • G4 Correct height of service wire achieved e.g. (5.5m @ road centre, 4.6m @ road edge, 3.0m over vehicle access.) When new POA/MCB installed by OCSC 2.7m @ 2.5m applies.

  • G5 Old hardware removed from Worksite

  • G6 Service wire installed across a boundary or pool

  • G7 Service wire installed to an accessible POA

Service / MCB Replacement

  • SV1 Bull Horn/pole/POA washer & split pin Installed for strain

  • SV2 Wedge clamps installed correctly

  • SV3 Flowline fuse/s mounted correctly

  • SV4 Correct XLPE conductor & line clamps installed and neat

  • SV5 Service wire doubled back for 6mm connection

  • SV6 Neutral tags applied to main line and service core (Total of 3 tags)

  • SV7 MCB condition compliant + shroud installed

  • SV8 Fuses / meter sealed and seals pulled tight

  • SV9 Correct vegetation clearance around service wire (min 300mm)


  • Add a drawing of the site to clarify any specifics identified

  • Add a drawing of the site to clarify any specifics identified SITE DRAWINGS


  • To be signed off by the Lead Auditor conducting the Audit

  • To be signed off by the person Controlling the Workplace

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.