018947 – ‘AS BUILT’ COMPLIANCE CERTIFICATION FOR TELSTRA SITE SHARE
Site Share Number	Revision Number:
Site Name	Node Manager Address ID:
Accredited Structural Design Company:
Access Seeker Company	Installation Company:

‘AS BUILT’ COMPLIANCE - REFERENCE DOCUMENTS
Reports / Drawings	Drawing No:	Sheet No:	Issue No:
Structural Design Certification: (018947f01)
Revised Structural Certification: (if applicable)
‘As Built’ Construction certification: (018947f02)
Truncated Pole Record 018947f03: (if applicable)
Concrete delivery docket / strength test results:(if applicable)
For Construction Structural Design Drawings: (Insert rows as required)
‘As Built’ Drawings : (Insert rows as required)

REFERENCE CONSTRUCTION PHOTOGRAPHS
Source	Date
Site Build Photo Record
RFNSA

‘AS-BUILT’ ENGINEERING COMPLIANCE CERTIFICATION (from the same ’Telstra accredited Site Share Structural Engineering Consultant’ that was engaged to complete the Structural Design)
I, (Civil/Structural Engineers Name)
of (Company Name)	Qualification:
certify that: Any change requests received from the construction project manager have been reviewed and revised structural design certification has been provided (if required). Based upon a desktop evaluation of the evidence provided, the ‘as-built’ installation meets the requirements of the latest Structural Design Certification (018947f01) referenced on this form.
Signed:	Date:

‘AS-BUILT’ EME COMPLIANCE CERTIFICATION (To be completed by the Access Seeker’s nominated representative with appropriate EME compliance qualifications.)
I, (Name)
of (Company Name)
certify that: I have checked the ‘as built’ installation and The ‘as-built’ installation meets the EME compliance requirements as per the document ‘005486 - Telstra Site EME Compliance and Safe Work Procedure’.
Signed:	Date: