Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

MCD Electrical Job Sheet.

JSA/Take 5

  • Has a JSA/Take 5 been completed ?

Job Date

  • Select date

  • Job Complete ?

Customer Name

Customer Address

Customer Phone Number & Email

Job Description

Sketches of Work Carried Out

  • Add drawing

  • Add media

Materials Used

Electrical Worker # 1

  • Electrical Worker # 1

  • Start Time

  • Finish Time

Electrical Worker # 2

  • Electrical Worker # 2

  • Start Time

  • Finish Time

Electrical Worker # 3

  • Electrical Worker # 3

  • Start Time

  • Finish Time

Additional Worker(s)

I Agree that the electrical work was performed at the above address. I acknowledge that all parts remain the property of MCD Electrical until full payment has been made.

  • Customer's Signiture

I certify that the electrical installation,to the extent it is affected by the electrical work,has been tested to ensure it is electrically safe and is in accordance with the requirements of the wiring rules and any other standard applying to the electrical installation under the Electrical Safety Regulation 2002.

I certify that the cabling work provided,complies with the Australian Communication Industry Wiring Rules technical standard AS/ACIF S009:2001

  • Worker's Signiture

  • Have the Electrical Test Results been recorded and forwarded on to Office?

  • Safety Switches Tested

  • Has the area been left clean and tidy

Additional Information

  • Add drawing

  • Photographic Information

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.