Job Number

  • Job Number

Work Activity

  • Work being carried out

Test Results

  • Circuit or Equipment

  • Visual Inspection

  • Circuit No

  • Protection Size and Type

  • Neutral No

  • Phase

  • Cable Size

  • Continuity Test (ohms)

  • Insulation Resistance (MEGohm)

  • Polarity Test Equipment or Circuit

  • Fault Loop Impedance Test (ohms)

  • Operational Test

Any Sketches, Pictures or Notes

  • Sketches for Report

  • Pictures for Report

  • Notes

Sign Off

  • Tested By

  • Electrical Worker in Charge

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