Monthly Emergency Light Test Report

• Site

• Concerto PPM Event Number

• Location
  Address

• Conducted on

  Date

• Prepared by

CDM

• Is there anything that you have been made aware of

• Have you seen the asbestos register for the site

  Yes

  No

  N/A

• Is there a toilet and washing facilities on site

  Yes

  No

  N/A

• Risk of falls from height

  Yes

  No

  N/A

• Risk of collapse of excavation

  Yes

  No

  N/A

• Risk of collapse of structure

  Yes

  No

  N/A

• Risk of exposure to building dust

  Yes

  No

  N/A

• Risk of exposure to asbestos

  Yes

  No

  N/A

• Supervision required

  Yes

  No

  N/A

• Electrical works

  Yes

  No

  N/A

• Are you following safe electrical procedures?

  Yes

  No

• Risk to others

  Yes

  No

  N/A

• Other dangers

  Yes

  No

  N/A

Test Report

• Emergency Light No. / Designation

• Flick test Pass or Fail?

  Pass

  Fail