Title Page

  • Conducted on

  • Prepared by

  • Job Number

  • Client / Site

  • Location

Test Equipment

  • Test equipment type

  • Manufacturer

  • Model Number

  • Serial Number

  • Inspection tag photo

Equipment Testing

  • Equipment Testing

  • Equipment
  • Equipment type

  • Manufacturer

  • Model Number

  • Serial Number

  • Is the cable in good condition? (No inner insulation exposed, no cuts, no kinks etc.)

  • What size is the cable?

  • How many cores does the circuit have?

  • Insulation test and earth continuity test is not applicable.

  • Insulation resistance - L1 to Earth (MΩ)

  • Insulation resistance - N to Earth (MΩ)

  • Insulation resistance - L1 to Earth (MΩ)

  • Insulation resistance - L2 to Earth (MΩ)

  • Insulation resistance - L3 to Earth (MΩ)

  • Insulation Resistance - L1 to Earth (MΩ)

  • Insulation Resistance - L2 to Earth (MΩ)

  • Insulation Resistance - L3 to Earth (MΩ)

  • Insulation Resistance - N to Earth (MΩ)

  • Earth continuity (Ω)

  • Is an RCD fitted to the equipment?

  • Did the RCD successfully operate?

  • Did all equipment tests pass?

  • Quick summary of any outstanding issues

  • Attach photos of equipment

  • Name and signature

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.