Template

Telecom Duct Blockage Survey Checklist

by SML Office, from the Community

10+

The A55 field survey checklist supports telecom duct and chamber works, including single or multiple blockages, new track, desilting, pole and buried chambers, and seized frame and cover fixes. Capture surface type, address, coordinates, traffic management, survey requirements, bore depth and fullness, cable counts and types, duct type, JUF and JRC box types, and distances between boxes and blockages. Add APX annotations and required photos of chambers, duct mouths, markers, and surroundings to document locations and plan desilting, gully suck, or new track remedial works.

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Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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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
Blockage Report (A55)
This Blockage Report (A55) template helps field engineers document and assess telecom duct blockages across chambers and poles. Capture chamber types, duct sections, DP IDs, distances to blockages, and required photos, including chamber surroundings, internal views, rods in duct, poles, and marked locations. Record surface types, void distances, and confirm footway and carriageway requirements. Include Openreach map references, overhead solutions, and sign-off. Streamline surveys and support safe, compliant repair planning.
by Mehran Khan, from the Community
Downloads: 0
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Template
Swish Yorkshire A55 Telecom Works Template
This Swish Yorkshire A55 template standardizes telecom network adjustment requests and surveys. Capture PIA NOI number, PN and asset affected, site contact and local authority. Record A55 purpose, overhead issues, poling help desk contact, alternative routes, and equipment to be added with dimensions. Log DP numbers, existing pole size and class, current and forecast wires, side load and private property status. Document chamber locations, surface types, traffic management needs, bores, use of 25mm rods, bore capacity, proposed cable or subduct, and duct type. Map locations using Eastings and Northings and what3words, with required photos of chambers, ducts and blockage points. Track distances between chambers and blockages, multiple blockages, and required chamber types. Include X and Y coordinates for works, number of ducts, duct section numbers, possible cable recovery, evidence of damage, Openreach references, total duct section length, and permissions to dig. Finish with work description, photos, and signature.
by Harry Lynch, from the Community
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Template
A55 Return Form for Telecom Duct Blockages
Use this A55 Return template to document telecom duct blockages and related site details. Record job identifiers, location, contractor, chamber descriptions, surface type at blockage, and distances from chambers. Capture duct references, measured length, number of bores, cables present, and current bore capacity. Log rods used by size, add photos showing approach, rods in bore, receiving bore, and any markings applied to indicate the blockage. Note whether traffic management is required and if the section lies on a red route, bus lane, or cycle lane. Include additional comments to support planning and remediation.
by Mark Jones, from the Community
Downloads: 10+
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Template
Underground Duct Condition Survey Checklist
Use this underground duct condition survey checklist to assess the state of buried duct networks. Capture access point information, evaluate duct occupancy from empty to extremely full, document health and safety issues, and attach photos for evidence. Include location, personnel, and client or site details, plus signature with time and date for accountability. This template helps teams standardize inspections and plan maintenance for telecom or utility duct infrastructure.
by Ash Kalhor, from the Community
Downloads: 30+
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Telecom Duct Blockage Survey Checklist

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Blockage Report (A55)

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You might also like

Blockage Report (A55)

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