Title Page

  • Audit Title

  • Conducted on

  • Requested by

Member Information

  • Name:

  • Service Address:

  • Location #:

  • Notes:

Meter Information

In:

  • Meter #:

  • Name:

  • Reading:

  • Location #:

  • Notes:

Out:

  • Meter #:

  • Name:

  • Reading:

  • Location #:

  • Notes:

Transformer/Regulator/Capacitor/OCR Information

Up:

  • Serial #:

  • Volts:

  • Size (KVA):

  • Type:

  • Make:

  • Location Served:

  • OH or URD:

  • Notes:

Down:

  • Serial #:

  • Volts:

  • Size (KVA):

  • Type:

  • Make:

  • Location Served:

  • OH or URD:

  • Notes:

Construction Jobs

  • WO #:

  • Location #:

  • Description:

Retirement Jobs

  • WO #:

  • Location #:

  • Description:

Outage Information

OH Outage:

  • Location #:

  • Name:

  • Cause Description:

  • Notes:

URD Outage:

  • Location #:

  • Name:

  • Cause Description:

  • Notes:

Member Issue

  • Location #:

  • Name:

  • Member Issue Description:

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.