Title Page

  • Add media

  • Branch No.

  • Branch name

  • Conducted on

  • Prepared by

Branch summary & stats

  • Branch summary

  • Branch feedback

  • Regular power cuts ?

  • Is the phase rotation crossed ?

  • Alarms

  • Work order numbers

  • Availability %

Switchgear

Main incoming panel

  • Click to add Main incoming panel

  • Main incoming panel
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type and size

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

Other main panels

  • Click to add other main panels

  • Other main panels
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Phasing type

  • Location

  • General condition

Shop panel

  • Click to add shop panel

  • Shop Panel
  • Manufacturer

  • Phasing type

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

Distribution boards

  • Click to add distribution boards

  • Distribution board
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

Essential Services Panel

  • Click to add service panel

  • Service Panel
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

PFC (Power Factor Correction)

  • Click to add PFC

  • PFC
  • PFC select working or not working

Voltage Optimisation Unit (Power Perfector etc)

  • Click to add Voltage Optimisation Unit (Power Perfector etc)

  • Voltage Opt Unit
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type

  • Location

  • General condition

Loose switchgear isolators etc.

  • Click to add loose switchgear isolators etc.

  • Switchgear/isolators
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset

  • Age

  • Type

  • Location

  • General condition

Main sub main cabling

  • Click to add main sub main cabling

  • Sub main cabling
  • Age

  • Type

  • Location

  • General condition

Sub circuit cabling

  • Click to add main sub circuit cabling

  • Sub circuit cabling
  • Age

  • Type

  • Location

  • General condition

Lighting (Sales floor)

  • Click to add lighting

  • Lighting
  • Age

  • Type

  • Location

  • General condition

Lighting BOH

  • Click to add lighting BOH

  • Lighting BOH
  • Age

  • Type

  • Location

  • General condition

Emergency lighting (sales floor)

  • Click to add emergency lighting

  • Emergency lighting
  • Age

  • Type

  • Location

  • General condition

Emergency lighting BOH

  • Click to add emergency lighting BOH

  • Emergency lighting BOH
  • Age

  • Type

  • Location

  • General condition

Any loose items

  • Click to add any loose items

  • Loose items
  • Visual check for any switches/ sockets that are damaged or broken

  • Photo of damage item

  • Description of damaged item

  • Is the item electrically safe

  • Report finding immediately and isolate until repair can be carried out

  • Location of damaged item

Refrigeration

R Panel

  • Click to ad R Panel

  • Panel
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type and Size

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

R1 Panel

  • Click to add R1

  • Panel
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type and Size

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

R2 Panel

  • Click to add R2

  • Panels
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type and size

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

R3 Panel

  • Click to add R3

  • Panel
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

Case Board

  • Click to add Case board

  • case board
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

DB case

  • Click to add DB case

  • case board
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

Other

  • Click to add Other

  • case board
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Phasing type

  • BS fuse type

  • Fuse type

  • Please select identification type

  • Location

  • General condition

Switchgear

  • Click to add switchgear

  • Switchgear
  • Manufacturer

  • Model number

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Mechanical isolators

  • Click to add mechanical isolators

  • Mechanical isolators
  • Age

  • Type

  • Location

  • General condition

Refrigeration isolators

  • Click to add refrigeration isolators

  • Refrigeration isolators
  • Age

  • Type

  • Location

  • General condition

Mechanical cabling

  • Click to add mechanical cabling

  • Mechanical cabling
  • Age

  • Type

  • Location

  • General condition

Refrigeration cabling

  • Click to add refrigeration cabling

  • Refrigeration cabling
  • Age

  • Type

  • Location

  • General condition

facilites

Fire alarm panels

  • Click to add main panel

  • Main panel
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Repeater panel

  • Click to add repeater panel

  • Repeater panel
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Devices

  • Click to add devices

  • Devices
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Cabling

  • Click to add cabling

  • Cabling
  • Age

  • Type

  • Location

  • General condition

Security

  • Click to add Intruder alarm main panel

  • alarm main panel
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Sub panels

  • Click to add sub panels

  • Sub panels
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Devices

  • Click to add devices

  • Devices
  • Age

  • Type

  • Location

  • General condition

Cabling

  • Click to add cabling

  • Cabling
  • Age

  • Type

  • Location

  • General condition

CCTV

  • Click to add CCTV

  • CCTV
  • Age

  • Type

  • Location

  • General condition

Rack and recording

  • Click to add rack and recording

  • Rack and recording
  • Age

  • Type

  • Location

  • General condition

Cameras

  • Click to add cameras

  • Cameras
  • Age

  • Type

  • Location

  • General condition

Cabling

  • Click to add cabling

  • Cabling
  • Age

  • Type

  • Location

  • General condition

Public addresses

  • Click to add main panel

  • main panel
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Speakers and microphones

  • Click to add speakers and microphones

  • Speakers/microphones
  • Age

  • Type

  • Location

  • General condition

Cabling

  • Click to add cabling

  • Cabling
  • Age

  • Type

  • Location

  • General condition

Generator

  • Click to add generator

  • Gernerator
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • If full store support and size

  • Fuel tank level

  • Fuel pipework general condition

  • Change over equipment and controls

  • Cabling

  • Age

  • Type

  • Location

  • General condition

External

  • Click to add lighting

  • Lighting
  • Age

  • Type

  • Location

  • General condition

Power

  • Click to add power

  • Power
  • Age

  • Type

  • Location

  • General condition

Car park management

  • Click to add car park management

  • Car park management
  • Age

  • Type

  • Location

  • General condition

Sprinklers

  • Click to add sprinkler pump control panel

  • Sprinkler control panel
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Sprinkler switchgear and controls

  • Click to add switchgear and controls

  • Switchgear and controls
  • Manufacturer

  • Model

  • Serial number

  • Barcode/Asset number

  • Age

  • Type

  • Location

  • General condition

Sprinkler wiring

  • Click to add sprinkler wiring

  • Sprinkler wiring
  • Age

  • Type

  • Location

  • General condition

Data/ telephone

  • Click to add data telephone

  • Data telephone
  • Age

  • Type

  • Location of main point

  • General condition

Roof lighting

  • Click to add roof lighting

  • Roof lighting
  • Age

  • Type

  • Location

  • General condition

Lighting protection

  • Click to add lighting protection

  • Lighting protection
  • Age

  • Type

  • Location

  • General condition

PFS

Main panel

  • Click to add main panel

  • Main panel
  • Manufacturer

  • Model number

  • Serial number

  • Age

  • Barcode/Asset number Cabinets

  • Type

  • Location

  • General condition

Switchgear

  • Click to add switchgear

  • Switchgear
  • Age

  • Type

  • Location

  • General condition

Fire alarm

  • Click to add fire alarm

  • Fire alarm
  • Age

  • Type

  • Location

  • General condition

Intruder alarm

  • Click to add intruder alarm

  • Intruder alarm
  • Age

  • Type

  • Location

  • General condition

Lighting

  • Click to add lighting

  • Lighting
  • Age

  • Type

  • Location

  • General condition

Small power

  • Click to add small power

  • Small power
  • Age

  • Type

  • Location

  • General condition

CCTV

  • Click to add CCTV

  • CCTV
  • Age

  • Type

  • Location

  • General condition

Generator

Generator

  • Click to add Generator

  • Generator
  • Please select Part load or Full load

  • Please check if load shedding is available

  • Is there a generator hook up point

  • Where would one be required ?

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.