Information

  • Document No.

  • Client / Site

  • Conducted on

  • Night /Day

  • Prepared by

  • Personnel present

  • Location

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

  • Approximate co ordinates
  • Station and location of plant being inspected

  • Photo of plant being inspected

  • Are the luminaries functional at the time of the inspection

  • Type of pole being inspected

  • Physical arrangement

  • Physical condition of pole

  • Does pole require modifications

  • Internal photos of pole and any external damage

  • Type and Physical condition of pit

  • Does the pit and conduits require flushing/clearing

  • It the earthing as per current standards

  • Photo of pit

  • Comments

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.