Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Business name:
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Business address:
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Business phone:
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Business type:
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Power company:
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Supply voltage:
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Meter number:
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Panel types:
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Types of controls:
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Access to lift on premises:
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Back-up generator:
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Does customer have a maintenance plan?
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Can we quote one?
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UPS:
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Hours of operation:
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EXTERIOR REVIEW:
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Meter clearances, proper installation, grounding:
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Notes, if fail:
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Parking lot lights:
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Fixture type:
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Fixture quantity:
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Ballast type:
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Control type:
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Pole height:
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Notes:
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Wall packs/building lights:
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Fixture type:
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Fixture quantity:
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Ballast type:
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Control type:
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Pole height:
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Notes:
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HVAC Disconnects:
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Notes, if fail:
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Exterior Outlets:
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Notes, if fail:
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Exterior Exit Remotes:
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Notes, if fail:
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Landscape Lighting:
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Notes, if fail:
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Signs and Menu Boards Operational:
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Notes, if fail:
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MAIN PANEL REVIEW:
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Condition:
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Notes, if fail:
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Proper Clearance:
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Notes, if fail:
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Thermal Scan:
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Notes, if fail:
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Breakers:
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Notes, if fail:
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Connections:
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Notes, if fail:
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Grounding:
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Notes, if fail:
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Arc Fault Protection:
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Notes, if fail:
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GFCI Protection:
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Notes, if fail:
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Surge Protection:
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Notes, if fail:
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Panel Labeled:
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Notes, if fail:
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Code Compliant:
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Notes, if fail:
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INTERIOR:
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Location:
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Room size:
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Light levels:
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Number of windows:
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Fixture type:
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Fixture qty:
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Ballast type:
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Control type:
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Notes, if other:
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Ceiling height:
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Test Switches:
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Notes, if fail:
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Test Outlets:
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Notes, if fail:
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GFCI:
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Notes, if fail:
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Test Smoke/CO:
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Notes, if fail:
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Exit Lights:
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Notes, if fail:
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Emergency Lights:
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Notes, if fail:
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General Notes / Special Equipment / Materials Used:
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Photos:
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Client Signature:
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Mr. Electric Signature:
