Page 1: Site Details

  • Prepared by

  • Site ID (Tower Number)

  • Please attach a photo of site ID placard on entrance gate

  • Conducted on

Page 2: Meter Specifications

  • Meter Number

Meter Face

  • Please attach photo of corresponding meter face

  • Service Disconnect Rating - Amps/Volts

  • Line Side Conductor Rating

  • Load Side Conductor Rating

  • Meter Number

Meter Face

  • Please attach photo of corresponding meter face

  • Service Disconnect Rating - Amps/Volts

  • Line Side Conductor Rating

  • Load Side Conductor Rating

  • Meter Number

Meter Face

  • Please attach photo of corresponding meter face

  • Service Disconnect Rating - Amps/Volts

  • Line Side Conductor Rating

  • Load Side Conductor Rating

  • Meter Number

Meter Face

  • Please attach photo of corresponding meter face

  • Service Disconnect Rating - Amps/Volts

  • Line Side Conductor Rating

  • Load Side Conductor Rating

  • Meter Number

Meter Face

  • Please attach photo of corresponding meter face

  • Service Disconnect Rating - Amps/Volts

  • Line Side Conductor Rating

  • Load Side Conductor Rating

  • Meter Number

Meter Face

  • Please attach photo of corresponding meter face

  • Service Disconnect Rating - Amps/Volts

  • Line Side Conductor Rating

  • Load Side Conductor Rating

Page 3: Transformer

  • Transformer type?

Transformer Details

  • Transformer ID#?

  • Please attach a photo of the transformer (including ID# if possible)

Page 4: Misc. Notes

  • Please note any outlying conditions or configurations

  • Please include a photo of above conditions/configurations where applicable

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.