S.N Items YES NO Remark Are all tools and equipment are in good 1 condition? Is the work is going on energized electrical 2 circuits? Are frayed or worn electrical cords or 3 cables are used? Are portable electric tool's cord and plug 4 are in good condition?
Are broken or damaged tools and
5 equipment are used?
Are portable electrical tools and equipment
6 are either grounded or of the double insulated type?
Are the distribution panels properly
7 earthed?
Is the job carried out in wet or damp
8 locations?
Are the equipment in use listed, labeled or
9 certified? Are ELCBs / RCCBs are provided in the 10 DBs & properly working?
Are electrical panel boxes are effectively
11 closed?
Any bypassing of protective system or
12 device designed to protect employees from contact with electrical current witnessed? 13 Are electrical cables physical damaged? Are all electrical equipment is used only as 14 approved and listed?
Inspected By : Inspected With :
Designation : Designation :
Sign : Sign :
Wk-Mgt-HSE-Insp-Rpt-01/09/15 age 1 of 2 Wk-Mgt-HSE-Insp-Rpt-01/09/15 age 2 of 2