390 Electrical Short Form New

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Outlets

Covers missing/broken/not secured

• Covers missing/broken/not secured

  Safe

  At Risk

  N/A
GFCI within 6 feet of water source

• GFCI within 6 feet of water source

  Safe

  At Risk

  N/A
GFCI not functioning/not tested

• GFCI not functioning/not tested

  Safe

  At Risk

  N/A

Conduit

Damaged/missing/wires exposed

• Damaged/missing/wires exposed

  Safe

  At Risk

  N/A

Condulet covers

Missing/wrong size

• Missing/wrong size

  Safe

  At Risk

  N/A

Junction box

Cover missing/not secured/wrong size

• Cover missing/not secured/wrong size

  Safe

  At Risk

  N/A
Strain relief missing

• Strain relief missing

  Safe

  At Risk

  N/A
Multi-branch circuits not labeled

• Multi-branch circuits not labeled

  Safe

  At Risk

  N/A
Knockouts missing

• Knockouts missing, not covered or replaced

  Safe

  At Risk

  N/A

Extension cords/temporary wiring

Used as permanent wiring

• Used as permanent wiring

  Safe

  At Risk

  N/A
Outer insulation cut/inner conductors exposed

• Outer insulation cut/inner conductors exposed

  Safe

  At Risk

  N/A
Grounding prong missing

• Grounding prongs missing

  Safe

  At Risk

  N/A
Improper splices

• Improper splices

  Safe

  At Risk

  N/A

Power cords

Splices taped or outside junction box

• Splices taped or outside junction box

  Safe

  At Risk

  N/A
Wiring pulled away from plug/junction box

• Wiring pulled away from plug/junction box

  Yes

  No

  N/A
Wires exposed/outer insulation damaged or cut

• Wires exposed/outer insulation damaged or cut

  Safe

  At Risk

  N/A

Obsolescent equipment or equipment no longer in service must be removed or the electrical service must be disconnected and wiring pulled back to the panel box.

Out of service electrical tagged and disconnected

• Out of service electrical tagged and disconnected

  Safe

  At Risk

  N/A

Light fixtures

Light fixtures less than 8' not protected

• Light fixtures lower than 8' not protected

  Safe

  At Risk

  N/A

MCC rooms

Not locked/secured against unauthorized access

• Not locked/secured against unauthorized access

  Safe

  At Risk

  N/A
No signage/incorrect signage on entrance door

• No signage/incorrect signage on entrance door

  Safe

  At Risk

  N/A

Disconnect, Panel box, breakers

30" area in front clear/free from clutter

• 30" area in front clear/free from clutter

  Safe

  At Risk

  N/A
Breakers not labeled/no breaker list

• Breakers not labeled/no breaker list

  Safe

  At Risk

  N/A
Missing/loose panel cover/exposed bus bar

• Missing/loose panel cover/exposed bus bar

  Safe

  At Risk

  N/A
Exposed wires

• Exposed wires<br>

  Safe

  At Risk

  N/A
No arc flash info present

• No arc flash info present

  Safe

  At Risk

  N/A
Missing breaker

• Missing breaker<br>

  Safe

  At Risk

  N/A
No voltage indicated on label

• No voltage indicated on label

  Safe

  At Risk

  N/A
No equipment identification on label

• No equipment identification on label

  Safe

  At Risk

  N/A
Protected from water damage/exposure

• Protected from water damage/exposure

  Safe

  At Risk

  N/A
Knockouts Missing

• Knockouts Missing <br>

  Safe

  At Risk

  N/A
Material stored on top

• Material stored on top

  Safe

  At Risk

  N/A

Grounding

AC systems not grounded

• AC systems not grounded

  Safe

  At Risk

  N/A
DC systems not grounded

• DC systems not grounded

  Safe

  At Risk

  N/A
Not connected to grounding rod

• Not connected to grounding rod

  Safe

  At Risk

  N/A
Grounding in place/good condition

• Grounding in place/good condition

  Safe

  At Risk

  N/A

Back up battery storage

Vent fans in place/operating correctly

• Vent fans in place/operating correctly

  Safe

  At Risk

  N/A

Welding machines

Disconnect in place/no physical damage

• Disconnect in place/no physical damage

  Safe

  At Risk

  N/A
Wiring pulled away from plug/junction box

• Wiring pulled away from plug/junction box

  Safe

  At Risk

  N/A

Turpentine areas (intrinsically safe?)

Electrical and conduit in turpentine areas is intrinsically safe and maintained.

• Electrical and conduit in turpentine areas is intrinsically safe and maintained.

  Safe

  At Risk

  N/A

Fire protective signaling systems must meet certain requirements.

Systems in place/ tested/operational

• Systems in place/ tested/operational

  Safe

  At Risk

  N/A