Information

  • Address

  • Conducted on

  • TechSafe Australia Job Number

Severely defective work report

  • Reporting inspector

  • Report date

  • Address
  • Contact details for person regarding worksite

  • Relation of person to site

  • Severely defective work identified when performing:

  • Do you believe the severely defective electrical work contributed to the cause or severity of the shock or fire?

  • Reasons why

  • CEC number

  • Contractor

  • Description of work as described on CEC

  • Description of severely defective work.

  • Are there other defects associated with the electrical work

  • Other defects

  • Photos of defective electrical work

  • Is it possible to identify the person who performed the electrical work?

  • Why is it not possible to identify person responsible for performing severely defective work?

  • Is the person responsible for the severely defective work the contractor identified in the CEC noted above?

  • Contractor/electrician responsible for severely defective work

  • Reason it is believed this person performed severely defective work

  • Contractor/electrician/person

  • Reason person is suspected of performing severely defective work

  • I believe this work constitutes severely defective work under the Occupational Licensing Act 2005, it poses an immediate danger to life or property with regard to Classification of Electrical Work Determination 8:

  • I have made the determination that the defective electrical work poses a:

Action taken

  • Defective Electrical Work notice issued to

  • Defective Electrical Work notice number

  • Action taken to disconnect or make safe

  • Disconnection details

  • Disconnection appropriately isolated and tagged

  • Person in charge of installation notified

  • Submain or subcircuit does not supply any life support equipment

  • Network service provider notified of disconnection

  • Checked with network service provider whether installation contains priority or life support customers

  • Chief Electrical Inspector or representative notified of impending disconnection

  • Person notified

  • Other relevant information

  • Add 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.