Title Page
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Conducted on
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Job number
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Site
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Prepared by
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Asset number
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Equipment
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Make
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Model
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Serial number
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Location of Equipment
Report
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Photograph of Unit
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Mains Cable, Plug & Socket Condition
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Lamps and Covers
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Control Switches / Contactors
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Contactors present and operational Control Knobs
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Thermostat and Calibration
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Motor operational
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Elements present and operational
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Internal wiring condition
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Water Tank / Steam Generator (scale)
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Filter
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Earth Bond
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Incoming Supply Voltage
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Sign Off
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Notes
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Parts Required