Equipment Check List

• Conducted on

  Date

• Prepared by

• Location
  Address

Multi Meter (Fluke 1587)

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Clamp Meter (Fluke i400)

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Crimp Tool (Cembre HT51)

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

SEW Leads

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

CT Leads

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Mitsubishi Lead

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Vacon Lead

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Schneider Lead

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Roline Danfoss

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Drives Window

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Drives Window Lite

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Microsoft Phone

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Laptop Tablet

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Laptop Bag

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

110v Blower

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

110v Extension

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

240v Extension

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Milwaukee Vacuum

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Milwaukee Battery

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Milwaukee Drill

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Milwaukee Jigsaw

• Serial Number

• Pat Tested?

  Yes

  No

  N/A

• Pat Test Date

  Date

• Calibrated?

  Yes

  No

  N/A

• Calibration Date

  Date

• Condition on Issue

  Used

  New

• Current Condition

  Usable

  Un-usable

• Comments

Sign Off

• Name and Signature

  Sign