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Splicing Productivity Form
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Work Date
*
MM
/
DD
/
YYYY
Crew Lead
*
Your answer
Map Number
*
Example: 721922816
Your answer
Terminal
*
Example: ZF021 42-46
Your answer
Aerial Terminals Spliced Each
Your answer
Aerial Terminals Spliced Burns
Number of Fibers Burns (UOM is number of splicing machine fusion sequences, not the number of fiber strands)
Your answer
Aerial Cases/Enclosures Spliced Each
Your answer
Aerial Cases/Enclosures Spliced Burns
Number of Fibers Burns (UOM is number of splicing machine fusion sequences, not the number of fiber strands)
Your answer
Aerial Terminals Tested
Test/Prep (No Splicing Completed)
Your answer
Aerial Terminals Prepped
Test/Prep (No Splicing Completed)
Your answer
Buried
Pedestals/Hand holes Spliced Each
Your answer
Buried Pedestals/Hand holes Spliced Burns
Number of Fibers Burns (UOM is number of splicing machine fusion sequences, not the number of fiber strands)
Your answer
Buried
Cases/Enclosures Spliced Each
Your answer
Buried Cases/Enclosures Spliced Burns
Buried Cases/Enclosures Spliced Each
Your answer
Buried Terminals Tested
Test/Prep (No Splicing Completed)
Your answer
Buried Terminals Prepped
Test/Prep (No Splicing Completed)
Your answer
Job Comments
Your answer
Meter Reading Photo Reminder
*
Make sure to submit a picture for this job with a visible light reading to
ws-splicing-pics@mercuryz.com
. Pictures must be submitted on the same day that the job is completed and must have a visible light reading. An example photo is shown below
Acknowledged
Required
Example Meter Photo
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