Electrical Safety Exit Check

• Address

  Select

• Conducted on

  Date

• Worker Performing Tasks

• Type of installation

  Select Domestic Commercial Industrial

  • Domestic
  • Commercial
  • Industrial

• Approximate age of installation

  0-5 years

  5-10 years

  10-15 years

  15-20 years

  20-25 years

• Is the job at hand an additions or alteration.

  Yes

  No

  N/A

• What are the works being performed?

• Are the works being undertaken the same as specified?

  Yes

  No

  N/A

• How are the works different?

Consumer Mains and Sub Circuits

• Visual Inspection

  Compliant

  Non Compliant

  Not Assessed

• Earth continuity

  Compliant

  Non Compliant

  Not Assessed

• Insulation Resistance

  Compliant

  Non Compliant

  Not Assessed

• Polarity

  Compliant

  Non Compliant

  Not Assessed

• Correct connection of wiring.

  Compliant

  Non Compliant

  Not Assessed

Switchboards

• MEN connection Intact.

  Compliant

  Non Compliant

  Not Assessed

• Basic protection against contact with live parts. e.g. insulation and enclosures.

  Compliant

  Non Compliant

  Not Assessed

• Identification and labelling of electrical equipment. e.g. switchboard markings and circuit identification

  Compliant

  Non Compliant

  Not Assessed

• RCD's installed on applicable circuits.

  Yes

  No

  N/A
Electrical Equipment

• General condition of electrical equipment.

  Good

  Fair

  Poor

  N/A

• Isolation devices installed where required.

  Yes

  No

  N/A

Earthing

• Connection, joints and terminations adequate.

  Compliant

  Non Compliant

  Not Assessed

General Condition of electrical installation

• Please state:

  Pass

  Fail

• What is not up to standard?

Exit Checks

• MEN connection intact

  Yes

  No

  N/A

• Switchboard secure.

  Yes

  No

  N/A

• Main switch and circuit protection returned to original state.

  Yes

  No

  N/A

• Tools and equipment returned to vehicle.

  Yes

  No

  N/A

• Has the site been cleaned and rubbish removed?

  Yes

  No

  N/A

• Person in control advised of departure.

  Yes

  No

  N/A

Photos or Videos of works before and after

• Add media

  Media

Sign Off

• Electrician:

  Sign

• Electrical safety check is carried out in accordance with AS/NZS Standards, we are not liable for any assessments carried out, or information contained within, as some installations will be applicable to previous standards.
  Note: cabling that is contained within the fabric of the building has not been checked.
  Approximately 10% of the electrical installation has been checked to give an approximate indication of the safety of the electrical installation