Template

LMS1 Existing Poles - Pole Upgrade Record

by Leon Robinson, from the Community

This LMS1 Existing Poles template is designed for recording inspections and upgrades of street lighting and utility poles. It captures station and location details, approximate coordinates, photos of poles and internal components, and the operational status of luminaires. Inspectors can select pole types and physical arrangements, note physical condition and required modifications, document pit types and condition, evidence of vermin, conduit cover, deformation, and serviceability, and verify earthing against current standards. The checklist supports comments, additional works required, and sign off by a representative.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions .

Template

Pole Inspection Form Template Final

Use this pole inspection form to scope and document the condition of utility poles. Capture location, pole type and condition, asset numbers, signage, possum guards, and landowner details. Assess crossarms by level, assembly type, material, and condition, and evaluate stays. Add comments and photos to build a complete record for maintenance and compliance across energy and telecommunications networks.

by Benjamin Hills, from the Community

10+

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Quality of Work Audit Checklist

This Quality of Work Audit checklist is designed for electric utility and pole line construction. It covers overhead construction components, pole installation and dressing, stays and earthing, pole-top assemblies, conductor sizing and terminations, substations and switches, LV and HV leads, labeling and warning signage, fastening and clearances, public lighting poles and heads, underground live jointing, retirement of assets, site reinstatement, and general housekeeping. Use it to verify compliance against standards, score nonconformances, and capture comments, photos, and signatures.

by Sheree Zwar, from the Community

200+

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Template

Work Order Inspection Checklist

This work order inspection checklist helps field teams assess and document utility pole work. Review assemblies, neutral spacing, transformer placement above the neutral, and presence of a power space marker. Verify correct location, pole composition, and that poles are properly tamped and not leaning. Capture photo evidence and note any trash around the pole. Record communications status, including STEMC fiber and other comms transfers, who completed them, and any items needing transfer. Confirm poles are in line, at the correct location, and meet utility standards to ensure safe, compliant completion of work orders.

by J K, from the Community

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Template

Pole-to-Pit Audit Form

This pole-to-pit audit form helps crews and inspectors confirm safe, compliant service installations from the utility pole to the pit. It covers pit location and trenching to the agreed pole, cable depth targets, conduit entry tolerances, and use of 63 mm orange conduit with marker tape. It checks pole guards and warning labels, PVC conduit height and extensions, secure fixings on timber and concrete poles, correct cable sizing such as 16 mm2 or 50 mm2 XLPE, and that cables are capped. It also verifies site reinstatement including footpaths and nature strips, and alignment with maps and offsets, with space for corrective actions and second audits.

by Ben Koutoukidis, from the Community

20+

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Template

Chorus Pole Attachment Feasibility Assessment

Use this structured checklist to evaluate the feasibility of attaching equipment to Chorus network poles. Record pole location and tag ID, capture full-pole photos and existing attachments, and specify equipment type and mounting method. Add components with weights, mounting height, and make or model, and include annotated images of intended attachment points. Suitable for CCTV, IoT sensors, road signs, street lamps, solar panels, traffic mirrors, and more. Includes safety guidance and notes that work on Chorus poles requires induction and approval.

by Jess Ellison, from the Community

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Template

Light Steel Pole Inspection Checklist

This light steel pole inspection checklist supports periodic assessments of lighting poles in the field. It guides inspectors through a site prestart, footing and rag bolt checks, grouting condition, conduit access and cable entry, and signs of corrosion. It also covers opening terminal covers to confirm tight connections, proper sealing, removal of built-up dirt, and secure reassembly. Include photos of the pole and record findings, issues, and actions to maintain lighting safety and reliability.

by Nagavishnu Sadasiva Panicker, from the Community

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LMS1 Existing Poles - Pole Upgrade Record

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