Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
Distribution identification
Building:
Level:
Room:
Manufacturer:
Serial#
Power Type:
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EMG
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Normal
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MLO
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MCB
Voltage
Amperage
Phase
Bus Type
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CU
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Alum
Feed from:
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LOTO needed
Feeder conduit & number
Conductor size & number
Prestart checklist
Review specs for proper requipments
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Select date
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Add signature
Gear fastened and mounted properly
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Select date
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Add signature
Gear is clean and dust free
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Select date
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Add signature
Unused openings properly sealed
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Select date
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Add signature
Seismic per spec ( if applicable)
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Select date
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Add signature
Torque form is completed and crossed checked
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Select date
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Add signature
Gear bonded and grounded per NEC and spec
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Select date
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Add signature
Megger form completed
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Select date
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Add signature
Lugs and bolts marked
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Select date
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Add signature
Inspect for physical damage
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Select date
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Add signature
3rd party GFCI breaker testing is complete
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Select date
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Add signature
Energize to main
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Per NFPA 70E and berg energized work policy. Required authorization from Mike Mueller before any power up
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Select date
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Add signature
Signature
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Berg QC:
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GC: