Inglett & Stubbs Pre Power Energization Form

• Document No.

• Job site/Number

• Equipment

Applies to: A. Any circuit over 1,000 volts B. Any low voltage circuits 800 AMP or above C. Any Service D. Re-energization after clearing faults E. Any Critical or Life Safety loads F. Any Owner-Job Specific requirements

• Conducted on

  Date

After installation and prior to energizing circuits, the following steps must be followed, approved, and forwarded as specified below.

• High Potential or Megger Test Complete

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• Visual Inspection completed for both ends on cable.

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• Cleanliness Checked

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• No loose items, moisture, etc...

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• Use meter to check phase to phase and phase to ground.

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• Lugs torqued and marked (both ends of cable)

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• All covers and hardware replaced

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

• Safety placement of personnel considered

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Owner Representative

  Sign

• Date

  Date

NOTE: Adequate time should be allowed for a site inspection by the Authorizing Agent.

Prior approval may be granted to allow a qualified independent third party (Representative of the Owner) to be substituted as an Authorizing Agent. This person is also required to sign the documentation and it must still be emailed prior to energizing.

• Supervisor

  Sign

• Journeyman Wireman

  Sign

• Authorizing Agent

  Sign

• Date

  Date

Email this form to Adrienne Graham from approval from one of the following personnel to energize: 1. General Superintendent 2. Division Manager 3. Vice President/President