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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SON Number
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Customer PO Number
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Part number
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Serial number
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Are you traveling in normal business hours?
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Number of traveling hours
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Number of working hours "NORMAL"
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Number of working hours "AFTER HOURS"
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Description of completed work
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Follow up visit required
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Are you satisfied with our service?
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Customer signature
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Certificate of Test and Safety for Electrical equipment. For electrical equipment, this certifies that the electrical equipment, to the extent it is affected by the electrical work, is electrically safe. NHP electrical contractor license number: 56476
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Date of test
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Name of person who performed, or person responsible for, the electrical work
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Signature of person who performed, or person who is responsible for, the electrical work
