Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

INSTALLATION DETAILS

  • Date:

  • Installation Address:
  • WARNING - WORKING ON LIVE CIRCUITS IS NOT PERMITTED.

    CIRCUITS SHOULD BE CORRECTLY IDENTIFIED, ISOLATED AND LOCKED OFF BEFORE DURING ANY WORKS COMMENCE.

END OF DAY INSPECTION

  • Confirm that all Works Carried Out are Compliant with Current Regulations.

  • All works Completed by Corsan are Protected by RCD?

  • Main Gas and Water Bonds are Present and are a Minimum of 6.0mm?

  • No live parts accessible?

  • Safety Shields Installed?

  • Bullet Socket installed at Cooker ensuring female end on the live supply?

  • Locking off kits installed on circuits which have been isolated? (ensure signs and tags have been applied).

  • Insert Image:

  • Bare cables (even if locked off) have choc block fitted?

  • Insert Image:

  • Debris cleared away and property clean and tidy?

  • Insert Image:

  • Circuits worked on have been tested?

  • Circuit
  • Circuit Name:

  • ZS:

  • DO NOT PROCEED - ANY CIRCUIT ALTERED OR ADDED MUST HAVE A TEST PERFORMED TO ENSURE IT IS SAFE TO RE USE.

  • Fridge Freezer Re Energised?

  • Occupant to Sign and Confirm:

DECLARATION

  • By signing this you are confirming the installation that has been carried out us safe to allow the occupant access and use of the system.

    Works carried out have been checked and are safe to re use.

    Circuits we have worked on have been tested even if a temporary measure to ensure safe to re energise.

  • Print & Sign:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.