Information

  • Client / Site

  • Document No.

  • Audit Title

  • Conducted on

  • Prepared by

  • Location
  • Technician Name & Surname

  • Technician Code

Unsuccessful Actions

  • Reason(s) for unsuccessful action:

  • Other - Reason

Successful Actions

Meter(s)

  • Meter Reading Nō1:

  • Meter Number:

  • Comments Meter Nō1:

  • Meter Nō1 Photos

  • Meter Reading Nō2:

  • Meter Number:

  • Comments Meter Nō2:

  • Meter Nō2 Photos:

  • Meter Reading Nō3:

  • Meter Number:

  • Comments Meter Nō3:

  • Meter Nō3 Photos:

Environmental Phases

  • Can installation be secured?

Technical Phases

  • Connection Type

  • Disconnection

  • Remove Breaker(s)

  • Link Isolator

  • Remove wire(s) to the meter?

  • Cap live wires?

  • Tag marked with date & IO code?

  • Remarks

Equipment condition:

  • What is the condition of the connectors:

  • Overall comments:

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.