Splicing Productivity Form

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First Name *

Last Name *

Work Date *

YYYY

Crew Lead *

Map Number *

Example: 721922816

Terminal *

Example: ZF021 42-46

Aerial Terminals Spliced Each

Aerial Terminals Spliced Burns

Number of Fibers Burns (UOM is number of splicing machine fusion sequences, not the number of fiber strands)

Aerial Cases/Enclosures Spliced Each

Aerial Cases/Enclosures Spliced Burns

Number of Fibers Burns (UOM is number of splicing machine fusion sequences, not the number of fiber strands)

Aerial Terminals Tested

Test/Prep (No Splicing Completed)

Aerial Terminals Prepped

Test/Prep (No Splicing Completed)

Buried Pedestals/Hand holes Spliced Each

Buried Pedestals/Hand holes Spliced Burns

Number of Fibers Burns (UOM is number of splicing machine fusion sequences, not the number of fiber strands)

Buried Cases/Enclosures Spliced Each

Buried Cases/Enclosures Spliced Burns

Buried Cases/Enclosures Spliced Each

Buried Terminals Tested

Test/Prep (No Splicing Completed)

Buried Terminals Prepped

Test/Prep (No Splicing Completed)

Job Comments

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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