Title Page

  • Client

  • Conducted on (Date and Time)

  • Inspected by

  • Address

Monthly Checklist

  • Area inspected (i.e., Transport Office)

  • Date and Time of Inspection

Emergency Light Checks

  • Emergency light inspection? Click "Add"

  • Emergency Light
  • Time on

  • Emergency light reference number

  • Emergency light location

  • Test results: Physical condition of equipment

  • Test results: Battery

  • Test results: luminous

  • Time off

  • Overall Assessment


  • Recommendations

  • Maintenance Inspector (Full 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.