Panel Safety Evaluation Survey

FIELD EVALUATION SAFETY SURVEY FOR ELECTRICAL PANELS

• Client Name:

• Conducted on

  Date
• Location
  Address

• Present at inspection:

  owner

  tenant

  other

  owner representative

• Prepared by

• Notes:

• Does the customer authorize the Beacon Electric Service professional to take pictures of the home for purposes of estimating future work?

  Yes

  No

• I authorize Beacon Electrical Services to take pictures of my home for the purpose of providing a written quote for electrical services.

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• Beacon Electrical Services - Panel Evaluation Survey

MESSAGE FROM THE OWNER OF BEACON ELECTRICALSERVICES

• Dear Valued Customer,
  
  Thank you for allowing us to design and evaluate the needs of your new electrical panel. Based upon our field evaluation and your needs we will design the most cost effective solution for your new electrical panel. We will also, if chosen for this project provide a high quality, safe install to ensure you and your family are safe for years to come.
  
  If you have any questions about this survey or if anything is not clear please do not hesitate to call.
  
  Kind Regards,
  
  Bob Hanifin, Owner
  BEACON ELECTRICAL SERVICE, INC
  Master Electrician
  Generac Certified
  
  703-367-0900 office
  
  
  

• How did you hear about us?

  Select Angie's List Internet search Facebook Pinterest Service Alley Google Referral

  • Angie's List
  • Internet search
  • Facebook
  • Pinterest
  • Service Alley
  • Google
  • Referral

• Have you ever had a bad experience with a contractor before?

  Yes

  No

  N/A

SECTION 1. INFORMATION ABOUT YOUR HOME

• Picture of front of House

  Media

• How old is your home?

• How many bedrooms are in your home?

  1

  2

  3

  4

  5

• How many finished square feet?

• Have you been experiencing any electrical problems within the house?

• Are you planning on any future upgrades or additions?

  Yes

  No

• Is there any where in your home where you wish you had a receptacle, switch or outlet?

  Yes

  No

  N/A

• Do you ever lose power in this neighborhood?

  Yes

  No

• Would you be interested in hearing about a fully automatic generator?

  Yes

  No

  N/A

• Are you planning on selling your house in the near future? Ie., Hot Tubs, Generators, Finished Basement, Additions, new appliances.

  Yes

  No

• When was the last time you had a Whole House Electrical Inspection Performed?

  Select Can't remember Never Within 5 years Over 10 years

  • Can't remember
  • Never
  • Within 5 years
  • Over 10 years

• Why it's a good idea to perform a Whole House Electrical Safety Inspection?
  -- Find and Correct Safety Hazards
  -- Peace of Mind
  -- Maintain Safety in Operation
  -- Insurance Agencies May Require a Risk Assessment Inspection
  

OVERLOADED CIRCUITS

• Do any of your circuits suddenly lose power due to a blown fuse or tripped circuit breaker?

  Safe

  At Risk

  N/A

• Do your lights ever flicker or dim?

  Safe

  At Risk

  N/A

SECTION 2. PANEL SAFETY SURVEY

PANEL SPECIFICATIONS

• Pictures of panel.

  Media

• Close up pictures of circuit breakers in panels.

  Media

• Panel Type

  Select BRYANT CUTLER HAMMER (BR TYPE) CUTLER HAMMER (CH TYPE) FEDERAL PACIFIC FUSE PANEL GE ITE PUSHMATIC SIEMANS SQUARD D (HOMELINE) SQUARD D (QO) ZINSCO OTHER UNKNOWN

  • BRYANT
  • CUTLER HAMMER (BR TYPE)
  • CUTLER HAMMER (CH TYPE)
  • FEDERAL PACIFIC
  • FUSE PANEL
  • GE
  • ITE
  • PUSHMATIC
  • SIEMANS
  • SQUARD D (HOMELINE)
  • SQUARD D (QO)
  • ZINSCO
  • OTHER
  • UNKNOWN

• AMPS of existing panel?

  Select 60 AMPS 100 AMPS 150 AMPS 200 AMPS 400 AMPS

  • 60 AMPS
  • 100 AMPS
  • 150 AMPS
  • 200 AMPS
  • 400 AMPS

• Panel protected by main breaker?

  Safe

  At Risk

  N/A

CIRCUIT BREAKER COUNTS

• 15 AMP SINGLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 20 AMP SINGLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 15 AMP GFCI SINGLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 20 AMP GFCI SINGLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 30 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 40 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 50 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 60 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 70 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 80 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 90 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

• 100 AMP DOUBLE POLE BREAKERS

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20

CODE VIOLATIONS

• Oversize / Undersized Circuit breakers

  Safe

  At Risk

  N/A

• Evidence of double tapped neutral conductors

  Safe

  At Risk

  N/A

• Evidence of overloaded circuit breakers

  Safe

  At Risk

  N/A

• Missing screws, connectors, knockouts

  Safe

  At Risk

  N/A

• Circuit breakers same manufacture

  Safe

  At Risk

  N/A

• Workmanship of existing wiring

  Safe

  At Risk

  N/A

• Ground Fault Circuit Interrupter installed by main panel.

  Safe

  At Risk

  N/A

• Condition of Grounding System

  Safe

  At Risk

  N/A

• Is panel schedule legible and accurately marked?

  Safe

  At Risk

  N/A

• Would you be interested in a pin point room-by-room typed panel schedule?

  Yes

  No

  N/A

• Is there adequate lighting in front of electrical panel?

  Safe

  At Risk

  N/A

• Is panel type a Federal Pacific or ZINSCO type?

  Safe

  At Risk

  N/A

• For addition information about Federal Pacific or ZINSCO Panels please refer to http://www.ismypanelsafe.com
  http://www.ismypanelsafe.com

• Comments

CONDITION OF PANEL

• Evidence of corrosion or water damage?

  Safe

  At Risk

  N/A

• Damaged circuit breakers

  Safe

  At Risk

  N/A

SURGE PROTECTION

• Panel protected by minimum 150,000 AMP surge protection.

  Safe

  At Risk

  N/A

• Comments

SECTION 3. SERVICE LATERAL AND METER

• PHOTOS OF METER AND LATERAL

  Media

• Is existing eyebolt safe?

  Safe

  At Risk

  N/A

• Condition of Meter.

  Safe

  At Risk

  N/A

• Condition of Service Entrance cable.

  Safe

  At Risk

  N/A

• Will it be necessary to remove bushes or trees to install new meter?

  Yes

  No

  N/A

• Is a roof penetration required?

  Yes

  No

  N/A

• How many feet of Service Entrance Cable are required?

• Comments

SECTION 4. GAS SUPPLEMENTAL GROUND

• Is gas meter properly grounded?

  Safe

  At Risk

  N/A

• How far from electric panel is gas meter installed?

• Comments

SECTION 5. GROUNDING ELECTRODE CONDUCTOR

• Does grounding electrode conductor require replacement to cold water shutoff location.

  Yes

  No

  N/A

• How many feet from main panel is main water shutoff located?

• Comments

SECTION 6. SUPPLEMENTAL GROUND RODS

• Are two ground rods visible?

  Yes

  No

  N/A

• Does anything impede the installation of the ground rods?

  Yes

  No

  N/A

• Comments

SECTION 7. INSTALLATION DETAILS

• Is there a 3 foot clearance in front of the panel as required by code.

  Yes

  No

  N/A

• Will new plywood backing be required?

  Yes

  No

  N/A

• On a scale of "1" to "10" with 10 being very difficult please rate degree of difficulty.

• Comments

SECTION 8. PERMIT INFORMATION

• Ask customer what county they live in.

  Select Alexandria Arlington Fairfax County Fairfax city Faquer County Loudoun County Manassas City Manassas Park Montgomery County Prince William County

  • Alexandria
  • Arlington
  • Fairfax County
  • Fairfax city
  • Faquer County
  • Loudoun County
  • Manassas City
  • Manassas Park
  • Montgomery County
  • Prince William County

• Type of permit required?

  Panel Upgrade

  Remove and Replace

• How many AMPS is existing panel?

  Select 60 AMPS 100 AMPS 150 AMPS 200 AMPS 400 AMPS

  • 60 AMPS
  • 100 AMPS
  • 150 AMPS
  • 200 AMPS
  • 400 AMPS

• AMPS service will be upgraded to?

  200

  400

  600

• Is service overhead or underground?

  Select OVERHEAD UNDERGROUND

  • OVERHEAD
  • UNDERGROUND

• Name of power company?

  Select BGE DOMINION POWER Manassas City Utilities NOVEC PEPCO

  • BGE
  • DOMINION POWER
  • Manassas City Utilities
  • NOVEC
  • PEPCO

• List any other items required on permit.

SECTION 9. MISS UTILITY REQUIREMENTS

• Will digging be required?

  yes

  no

• Does miss utility need to be called? If installing ground rods or digging the answer is 'YES'

  Select yes no

  • yes
  • no

• Where does property need to get marked? Please select the areas you will be digging or installing ground rods.

  Select Front of house Rear of house facing front of house mark left side facing front of house mark right side

  • Front of house
  • Rear of house
  • facing front of house mark left side
  • facing front of house mark right side

• TRENCH CERTIFICATION FORM: Fairfax and Prince William counties accept trench certification forms. Please be sure they are properly filled out and emailed to customer prior to inspection date.

• Comments

SECTION 10. INSPECTION INFORMATION

• Does power company need to pull meter morning of install?

  Select Yes No

  • Yes
  • No

• Does county inspection need to be conducted after 12 noon on day of install?

  Select Yes No

  • Yes
  • No

• Comments

SECTION 11. INSTALLATION SCHEDULE - WHAT TO EXPECT

• 1. A panel upgrade can take anywhere from 8 to 12 hours for difficult installs. Please note every install is custom and poses different challenges.
  2. Most homes are without out power for most of the day.
  3. COUNTY INSPECTIONS: Someone must be home the full day to meet with the county inspector.
  4. We do require full payment at the completion of the panel install.

SECTION 12. BEACON ELECTRICAL WARRANTY INFORMATION

• LABOR WARRANTY: Beacon Electrical Services offers a 5 year labor warranty which covers loose connections and faulty workmanship.

• PANEL WARRANTY: Beacon Electrical Services offers a LIFETIME product guarantee which covers defects in bus bars, ground bars, enclosure, and connectors. Circuit breakers are covered under manufacture product warranties and differs by manufacture.

SECTION 13. RESULTS AND RECOMMENDATIONS OF PANEL SAFETY SURVEY

• Overall health of your existing panel.

  Safe

  At Risk

  N/A

• Recommend Panel Upgrade

• Recommend Panel Replacement

• Recommend Servicing of main panel. The service is Recommended every 10 Years.

• Recommend installing additional Sub Panel

• Recommend Whole House Surge Protector

• Comments

• Has homeowner been advised that we do not repair drywall, or any other required surface repairs including painting?

  Yes

  No

  N/A

• I understand that drywall repair, Or any other service repair will not be included as part of Beacon Electrics Proposal.

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• Email a copy of this survey to: customer, yourself. Your copy can be stored in your iBooks on your iPad for future reference (see iAuditor 'how to' for support).
  
  For SCHEDULED or SOLD jobs please email a copy to DeniseH@BeaconElectricalServices.com to process permit application.
  

• I understand the information released will be used for a written quote only.

• Clients signature:

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