sin()
PROVEN

BINDER FORM

FRM-037

POWERLINE RECORD — 30M33

Site schematic and the record of the discussion with the power-system owner. Not a substitute for Form 30M33.

DOCUMENT
GOSPEL-FRM-037
REVISION
01 CURRENT
EFFECTIVE
2026-09-01
OWNER
GOSPEL Safety
APPROVED BY
GOSPEL
REVIEW
2027-09-01

FILL THIS FORM →

WORKSAFEBC FORM 30M33 →

BC HYDRO — WORKING NEAR POWER LINES / MAD →

SWP — WORKING NEAR POWERLINES →

Coded NCR form. Sample online. Order the working copy from WorkSafeBC. Only 30M33 is acceptable as the assurance in writing.

Express Connect 1 877 520 1355. Table 19-1A. Unknown voltage: 3 m distribution, 6 m transmission.

WHEN

Before the crane can enter the limits of approach. When lines, voltage or the radius change.

CAPTURE

  • Site, crane, work radius
  • Power-system owner and representative
  • Line voltage and location (sketch)
  • MAD this voltage — Table 19-1A metres (1 / 3 / 4.5 / 6)
  • Unknown voltage held at 3 m distribution or 6 m transmission
  • Transformers and cable hazards in the radius
  • What was agreed: displace, isolate and ground, or identify and guard
  • 30M33 number / date if issued
  • Who holds the coded form
  • Posted on the site board — yes / no

ROUTING

Completed with the utility representative. Coded 30M33 is ordered from WorkSafeBC and signed by the power-system owner. This sheet stays in the binder and on the board.

PROVENsin(). Current version on this site.