F0 35 MECHANICAL, ELECTRICAL & PERSONAL SAFEGUARDING

PORTABLE ELECTRICAL EQUIPMENT CHECKLIST

DEPARTMENT
YEAR

Notes: Do not “tick”. Write Ok or use the code of the specific deviation in the legend. If the Equipment is defective it must be tagged “Defective”
and must be reported to the person responsible for the repair of the equipment. If the equipment is beyond repair it must be destroyed and
discarded. New equipment to replace the discarded equipment must be obtained to discourage the use of make shift equipment.
LEGEND: OK – ALL IN GOOD CONDITION, ELM– EQUIPMENT LOST OF MISSING, REP – EQIPMENT BEING REPAIRED, C – COMMENTS
DEVIATIONS NOTED: ACTIONS TAKEN:
L1 Damaged Guard L9 Incorrect switch / dead man switch
L2 Uninstalled safety guard L10 Damage switch / dead man switch
L3 Damaged PEE casing L11 Earth wire/ground not connected
L4 Loose fittings, srews, bolts L12 Defective electric motor
L5 Damaged / Broken Handle L13 Defective / damaged drill bit, blade, etc
L6 Damaged electrical cords L14 PEE coroded and not lubricated
L7 Damaged/incorrect electrical plugs L15 PEE Illegally Modified
L8 Unsafe electrical connection/termination L16 No Serial / No Equipment ID Number

EQUIPMENT ID EQUIPMENT DESCRIPTION JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

NO Battery powered drill ACT DEV ACT DEV

Extension cord
Electrical tools
Hand tools
Heat Gun

INSPECTOR INITIALS

Prepared by: Approved by: Element 2.10 Page No: Page 1 of 1 Revision No: 00
Reference No: