Undercrossing/Overcrossing Control Sheet

This form is used for specifying Undercrossing and Overcrossing management controls. This Control Sheet must be completed and attached to the Field Access Authority:

RFA Number	-	Field Access Authority Number

Identify below all Undercrossings/Overcrossings in the affected work area and specify the controls which have been/are to be implemented. Additional sheets may be used if required:

Undercrossing/Overcrossing Description:
Undercrossing/Overcrossing Location:	Status:	In Service ☐ Isolated and Earthed ☐ Other entity AA issued ☐
If the crossing is to remain in service, Engineering controls must be implemented to prevent coming on or near.
Are these controls to be applied by the work party?	Yes o No o
If No, the controls must have been applied prior to the Issue of the Access Authority. The Access Authority Issuer must confirm the controls are in place prior to Access Authority Issue.

Undercrossing/Overcrossing Description:
Undercrossing/Overcrossing Location:	Status:	In Service ☐ Isolated and Earthed ☐ Other entity AA issued ☐
If the crossing is to remain in service, Engineering controls must be implemented to prevent coming on or near.
Are these controls to be applied by the work party?	Yes o No o
If No, the controls must have been applied prior to the Issue of the Access Authority. The Access Authority Issuer must confirm the controls are in place prior to Access Authority Issue.

Undercrossing/Overcrossing Description:
Undercrossing/Overcrossing Location:	Status:	In Service ☐ Isolated and Earthed ☐ Other entity AA issued ☐
If the crossing is to remain in service, Engineering controls must be implemented to prevent coming on or near. undercrossing/overcrossing risk:
Are these controls to be applied by the work party?	Yes o No o
If No, the controls must have been applied prior to the Issue of the Access Authority. The Access Authority Issuer must confirm the controls are in place prior to Access Authority Issue.