Epoch Form:

  1. Inspection: Creative Surveying, Pinnacl X, Mesa

  2. Line #’s: For multi-curcuit structures, oder lines from highest to lowest voltage. If two lines have same voltage, lowest line # comes first.

  3. Structure #’s: For multi-curcuit structures, oder lines from highest to lowest voltage. If two lines have same voltage, lowest line # comes first.

  4. Region: CT, NH, EMA (Eastern Mass), WMA (Western Mass)

  5. Designation: SCSP, SCWP, SCLP, DCWP, DCSP, DCLP, SCHF-WP, SCHF-LP, DCLT, Terminal, Other

  6. Structure Construction Material: Galvanized, Weathering, Natural Wood, Laminate Wood, Concrete, Fiberglass, Painted Steel

  7. Line/Bent (Steel): A-No Action, B-Minimal, C-Moderate, D-Severe

  8. Shell Rot: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  9. Rust (Steel): A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  10. Decay (Wood): A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  11. Pole Splits/ Breaks: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  12. Fracture: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  13. Insect Damage: Yes, No, N/A

  14. Woodpecker Holes (Location): N/A, Top, Middle, Bottom, Longitudinal to conductor, Transverse to Conductor

  15. Woodpecker Holes (Severity): A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  16. Danger signs missing/damaged: Yes, No, TBD

  17. Guy Anchor Marker: Yes, No, N/A, TBD

  18. Guy/Anchor Problems: None, Loose, Disconnected, Rusty

  19. Hardware Damage: A-No Action, B-Minimal, C-Moderate, D-Severe

  20. Crossarm Damage (Severity): A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  21. Crossarm Splits/Breaks: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  22. Down Lead/GW Problems: Disconnected, Loose, Missing, No Issue, TBD

  23. Insulator Configuration: Strain, Suspension, Both, Other

  24. Insulator Condition: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  25. Num. Insulator Chipped/ Broken per Strings: 0,1,2,3,4,5,6,7,8,9,10+

  26. Conductor Damage (Severity): A-No Action, B-Minimal, C-Moderate, D-Severe

  27. Conductor (Location): N/A, Bottom, Middle, Top, East, West, South, North

  28. Conductor Strands: A-No Action, B-Minimal, C-Moderate, D-Severe

  29. Conductor Splice: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  30. Conductor Attachment Point: A-No Action, B-Minimal, C-Moderate, D-Severe

  31. Conductor Burned: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  32. PCS Antennas on Structure: Yes, No

  33. FAA Lighting: Yes, No, Not Functioning

  34. Marker Balls: Yes, No, (If damaged, add comment below)

  35. Lighting Arrestor (LA): Yes - chain intact, Yes - chain disconnected, N/A

  36. OPGW Splice Can & Grounding Installed Correctly: Yes, No, N/A

  37. Culvert Open: Yes, No, N/A

  38. Culvert Condition: A-No Action, B-Minimal, C-Moderate, D-Severe, N/A

  39. Line Angle: Tangent, Angle

  40. Ground Clearance Concern: Yes, No

  41. High Brush/Trees: Yes, No

  42. Hazardous Trees: Yes, No

  43. Access Problems: Accessible by vehicle, Accessible by utility vehicle, Accessible only by foot, Not Accessible, Not accessible due to unexpected condition

  44. Steps Lower than 12 Feet: Yes, No

  45. Encroachments: Yes, No

  46. Erosion: A-No Action, B-Minimal, C-Moderate, D-Severe

  47. Bird Nest: Yes, No

  48. Counterpoise: Yes, No

  49. Overall Structure Condition: A-No Action, B-Minimal, C-Moderate, D-Severe

  50. Misc. Problems: A-No Action, B-Minimal, C-Moderate, D-Severe, None

  51. Assigned To: PinnaclX

  52. Reason for Not Being Inspected:

  53. AGL (Feet):

  54. Misc. Notes:

  55. Inspection Date:

  56. Lead Inspector Name: Al Gates

  57. Vendor Reviewer QA/QC: K. Swift Date:__________

  58. ES Reviewer: Name:___________ Date:__________