Emergency Lighting Function Test (M)

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Service Visit Type

  Select

• Location

• Plant Description

• Asset Reference

RAMS

• Risk assessment completed

  Yes

  No

  N/A

• Method statement completed

  Yes

  No

  N/A

• PPE

• Engineer Initials

• Switch on in the emergency mode each luminaire and each internally illuminated exit sign from its battery by simulation of a failure of the supply to the normal lighting for a period sufficient to ensure that each lamp is illuminated. During this period, all luminaires and signs should be checked to ensure that they are present, clean and functioning correctly. (ADD PHOTOS ON THIS SECTION) <br>PLEASE LIST FAILED LUMINAIRES AND LOCATION IN THE COMMENTS SECTION.

  Pass

  Fail

  N/A

• At the end of this test period, the supply to the normal lighting should be restored and any indicator lamp or device checked to ensure that it is showing that the normal supply has been restored.

  Pass

  Fail

  N/A

Additional Comments

• Report of any faults

Safety checks

• Inspection Completed

  Yes

  No

  N/A

• Area left safe

  Yes

  No

  N/A

• Area left clean

  Yes

  No

  N/A

Polyteck Building Services, 143 Leman Street, London, E1 8EY

• Engineer signature