Site electrical inspection

ELECTRICAL SAFETY REPORT

• Client

• Job/PO# Number

• Location
  Address

• Reason for inspection

TYPE OF SERVICE PERFORMED: (tick as required)

• Visual safety examination / inspection

• Make safe

• Complete electrical test

• Partial visual examination or electrical test (List areas inspected)

SITE HAZARDS (tick required)

• undefined

  Select Wet Conditions Overhead Power Lines Damaged or Faulty Equipment/ Tools Dangerous Wiring Exposed Electrical Parts Damaged Insulation Other

  • Wet Conditions
  • Overhead Power Lines
  • Damaged or Faulty Equipment/ Tools
  • Dangerous Wiring
  • Exposed Electrical Parts
  • Damaged Insulation
  • Other

WORKS CARRIED OUT

• undefined

  Select Visual Inspection Tested Repaired Made Safe Requires attention/ Immediate disconnect Other

  • Visual Inspection
  • Tested
  • Repaired
  • Made Safe
  • Requires attention/ Immediate disconnect
  • Other
DETAILS OF DEFECTS FOUND:

• List of defects found

ELECTRICAL WORKER IN CHARGE

• Name:

• Signature:

  Sign

• Licence Number:

• Date:

  Date