Title Page

Meeting Information

  • Inspection Date / Time

  • Employee Name

Member Information

  • Member Name

  • Member Address
  • Meter Number

Member Issue

  • Blinking

  • Dimming

  • Flickering

  • Bright / Dim

  • Frequent Outages?

  • How often Does this occur?

  • Comments

Service Information

  • Transformer KVA

  • Service Wire Size

  • Service length

  • Service Entrance Wire Size

  • Service Entrance Wire Type

  • Open Wire Secondary

  • Open wire secondary size

Meter Pan Information Prior to Reworking

Voltage under load

  • Left Lug to Ground

  • Right Lug to Ground

  • Right Lug to Left Lug

Connection in Meter Pan

  • Top Left

  • Top Center

  • Top Right

  • Bottom Left

  • Bottom Center

  • Bottom Right

Weatherhead Information

  • Check connections at weather head (remove tape) Comments

  • Check service wire from weather head to transformer Comments

Transformer Voltage

  • Left Phase to Ground

  • Right Phase to Ground

  • Phase to Phase

Transformer Connections

Low Side

  • Left Lug

  • Center Lug

  • Right Lug

  • Comments

High Side

  • Hotline Clamp Condition

  • Add or Replace Saddle

  • Insulated Copper and Animal Guard

  • Convert Fuse kit to Cutout and Arrestor

  • High Side Bushing Condition

Final Assessment

Meter Pan Voltage (Under Load)

  • Left Lug to Ground

  • Right Lug to Ground

  • Right Lug to Left Lug

  • Comments if Necessary

  • Photos if Necessary

  • Sketch of Necessary

  • Employee Signature

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.