CON 08 115B SORN Request Form for HV ICP Jointing Activity - Mechanism 1

UK Power Networks CON 08 115b

SORN Request Form for HV ICP Jointing Activity – Mechanism 1

1 ICP Company Name

2 Project Name & Site Address

3 UK Power Networks Project Number

4 UK Power Networks License Area

5 Work Start Date 6 Work Finish Date

DNO HV Circuit ID – 7  Primary/MSS name & Feeder No. or name  Circuit destination between Sub-Station’s

8 Description of work to be completed

Name and NERS Passport reference numbers of 9 jointing team(s)

ICP Declaration

I confirm all Works will be completed in accordance with the accepted design and the G81 design standards.

I understand that the Works will be limited to “connection activity” and will not include any “operational activity”.

I understand that the connection activity shall be completed in accordance with the ICP’s own Safe System of Work which shall be to no lesser standard than UK Power Networks policies & procedures.

I understand that the ICP shall have in place arrangements for emergency circuit restoration and have a nominated representative contactable for the duration of the works, inclusive of out of normal working hours.

Name: Position: Signature: Date:

Version 2.1 UK Power Networks Use Only

SORN Status Date Name Signature Provisional Confirmed Withdrawn Site Completion Closed

SORN Reference Number HV-M101 SORN Version Number v1.0

SORN Version Comments Date of Revision Number V2.0 V3.0 V4.0

Version 2.1