QMF 380 Electrical Supervisors Inspection Report

• Conducted on

  Date

• Prepared by

• Location
  Address

• Contract/Client

• Operative(s) assessed:

• Operative Grade:

  Level 1

  Level 2

  Level 3

• Operative(s) Line Manager:

• List Principal Operations:

Health & Safety / Housekeeping

• Are the Operative(s) wearing their Company ID and uniform?

  Yes

  No

  N/A

• If Asbestos is presumed is Cat A or Cat B procedure followed? (please detail)

  Yes

  No

  N/A

• Is mandatory PPE being worn? (i.e. Safety footwear & trousers) and is there any requirement for additional PPE (please specify) for the task in hand?

  Yes

  No

  N/A

• MD Safe isolation procedures being carried out (3 point isolation and/or device locked off) and warning notices erected?

  Yes

  No

  N/A

• Are any walkway, accesses or workplaces obstructed with rubbish. Leads, equipment or any other trip hazard?

  Yes

  No

  N/A

Plant & Equipment

• Has all plant & equipment been checked prior to use and are suitable for the job in hand?

  Yes

  No

  N/A

• Has all plant & equipment onsite been PAT?

  Yes

  No

  N/A

• Has the test kit been calibrated (annually) and verified by check box (monthly)?

  Yes

  No

  N/A

• MFT Make/Model:

  Media

• MFT Serial Number:

  Media

• Does Test equipment comply with GS38 regulation?

  Yes

  No

  N/A

• Is the Company vehicle clean & tidy?

  Yes

  No

  N/A

• Have you sample tested the following results & compared to engineers’ reading and confirm with tolerances?

  Yes

  No

  N/A

• Correct polarity & Ze reading correct at origin

  Yes

  No

  N/A

• Zs reading with tolerance (specify circuit)

  Yes

  No

  N/A

• RCD trip times correct (specify circuit)

  Yes

  No

  N/A

• (Please details results & relevant circuits)

• Notes/Comments/Actions

• Actions completed?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Sign

  Sign

• Date

  Date