Title Page
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Inspection Number
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Equipment Type
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Department
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Conducted on
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Tester
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Location
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Foreman +Crew Members
Equipment Information
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Equipment Type (Bucket, digger, liner, pole saw etc.)
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Manufacturer
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Unit #
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Model #
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Serial #
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Category (A,B,C)
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Humidity Level at time of test
Test Data
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Date and time of actual testing
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Upper Boom Tested at 56kv
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Leakage in Micro amps
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Reject
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Pass or Fail
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Lower Insert Tested at 56kv
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Leakage in Micro Amps
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Reject
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Pass or Fail
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Bucket Liner #1 Tested at 100kv
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Pass or Fail
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Bucket Liner #2 Tested at 100kv
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Pass or Fail
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Testing Decal Applied?
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Comments:
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Tester Signature
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Operators Signature