Electrical Review

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Location

• Add location
  Address

Who is at risk?

• Are employees at risk

  Yes

  No

  N/A

• Are contractors at risk?

  Yes

  No

  N/A

• Are members of the public at risk

  Yes

  No

  N/A

Fixed Electrical Systems

• Have all fixed electrical systems been inspected?

  Yes

  No

  N/A

• Are records kept?

  Yes

  No

  N/A

Portable Appliances

• Have all electrical appliances been tested

  Yes

  No

  N/A

• Are records kept?

  Yes

  No

  N/A

Information

• Is there a notice displayed with regards to electrical shock treatment?

  Yes

  No

  N/A

• Have all employees received instruction in the use of electrical equipment?

  Yes

  No

  N/A

Physical Checks

• Are wall sockets free from damage, burns, or showing signs of over heating?

  Yes

  No

  N/A

• Are cables free from damage?

  Yes

  No

  N/A

• Are plugs free from damage?

  Yes

  No

  N/A

• Are cables securely fixed at the plug and apparatus?

  Yes

  No

  N/A

• Are the correct fuses fitted into plugs?

  Yes

  No

  N/A

• Are the portable appliances and flexible cables in good condition?

  Yes

  No

  N/A

• Is the equipment suitable for the task to be performed?

  Yes

  No

  N/A

Overall risk rating

• What is the overall risk rating?

  High

  Medium

  Low

Remedial actions required

• Actions required

Assessment completed by

• Add signature

  Sign