Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Site Contact Details

  • Site managers name

  • Site managers contact number

Site operating hours

  • How many days per week is site open in normal operation

  • How many hours a day is site open in normal operation

  • How many days is site closed per year

Powerstar Type

  • Powerstar Type Required

  • Required Headroom

  • Powerstar specified match demand

  • HMW required ( 3rd zigzag winding to reduce harmonics - optional )

  • HMI required ( IP address metering system - optional )

  • GSM comms required

  • Under-voltage controller type

  • Bypass switch required ( BBM recommended )

  • If the unit is to be positioned outside is a GRP housing required

Supply Details

  • Electricity Supplier

  • Electricity Supplier contact number

  • MPAN number

  • Maximum Demand kVa / kW

  • Metered on which side

  • Power Factor

  • Number of supplies per MPAN

  • Size of LV transformer in kVa

  • Transformer Tapping %

  • Is Transformer owned by client

  • Voltage rating of main incomer

  • Amp rating of main incomer

  • Largest size downstream breaker

  • Add picture of main incomer

Panel meter or main meter spot reading

  • Enter meter type

  • Enter meter manufacturer

  • Enter meter serial number

  • Add picture of meter

  • Does meter allow engineer readings

  • L1 Voltage

  • L2 Voltage

  • L3 Voltage

  • Total kVa

  • L1 Amps

  • L2 Amps

  • L3 Amps

  • Total kW

  • Power Factor

Logger Details and Spot Readings

  • Logger ID (head)

  • Logger location (head)

  • Logger ID (eol)

  • Logger location (eol)

  • Spot reading 1

  • Location of spot read 1

  • Spot read 2

  • Location of spot read 2

  • Spot read 3

  • Location of spot read 3

  • Spot read 4

  • Location of spot read 4

  • Spot read 5

  • Location of spot read 5

  • Spot read 6

  • Location of spot read 6

Eligible Load for Carbon Trust

  • Lighting with magnetic ballast

  • Lighting with no ballast

  • Uncontrolled resistive loads

  • Motors - poor efficiency

  • Motors - medium efficiency

  • Motors - high efficiency class EEF 1/2

  • IT load - non flat screen

  • Add pictures of devices

In eligible load for PowerStar

  • 1. High frequency lighting ( T5 or T8 )

  • 2. Space heating ( electric )

  • 2. DHW ( immersion, coffee machines, kettles etc )

  • 2. Catering ( electric heating )

  • 2. Process heating

  • 3. Hydraulic lift motors

  • 3. DC motors

  • 4. A/C units - VRV

  • 4. Motors with VSD

  • 5. IT - FLT screens

  • 5. UPS

  • 6. Compressors

  • 6. Multistage Chillers

  • 6. Battery Chargers

  • 6. Welding machines

  • Add pictures of devices where appropriate

Large Motor Details

  • Add make model and operating voltage of any 3ph / 440v lift motors

  • Add picture of lift motors if possible

  • Add make, model and operating voltage of any rotisserie

  • Add picture of rotisserie

  • Add make, model and voltage of ovens

  • Add picture of ovens

Site Plan

  • Will an install survey be required

  • Add measured plan of VO location including height

  • Add location pictures

Site Access Description

  • Describe any restrictions along access route from entrance to building to location of VO

  • Add pictures of any restrictions

Additional Information

  • Add any additional relevant information

  • Surveyors 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.