Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Distribution identification

Building:

Level:

Room:

Manufacturer:

Serial#

Power Type:

  • EMG

  • Normal

  • MLO

  • MCB

Voltage

Amperage

Phase

Bus Type

  • CU

  • Alum

Feed from:

  • LOTO needed

Feeder conduit & number

Conductor size & number

Prestart checklist

Review specs for proper requipments

  • Select date

  • Add signature

Gear fastened and mounted properly

  • Select date

  • Add signature

Gear is clean and dust free

  • Select date

  • Add signature

Unused openings properly sealed

  • Select date

  • Add signature

Seismic per spec ( if applicable)

  • Select date

  • Add signature

Torque form is completed and crossed checked

  • Select date

  • Add signature

Gear bonded and grounded per NEC and spec

  • Select date

  • Add signature

Megger form completed

  • Select date

  • Add signature

Lugs and bolts marked

  • Select date

  • Add signature

Inspect for physical damage

  • Select date

  • Add signature

3rd party GFCI breaker testing is complete

  • Select date

  • Add signature

Energize to main

  • Per NFPA 70E and berg energized work policy. Required authorization from Mike Mueller before any power up

  • Select date

  • Add signature

Signature

  • Berg QC:

  • GC:

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