Emergency Services Coordination Consent Form (Telecom Site)
Site & Coordination Details
Project/Site Name
Site Address
Date
Time
Consent & Liaison Information
Responsible Person Name
Contact Number
Emergency Services Contacted
Details of Coordination/Notice Given
Consent Confirmation
I confirm coordination with relevant emergency services for activities at this site.
Additional Comments
Signatures
Responsible Person Signature
Date
Witness Name & Signature
Date