Withdrawal Document

(Element 1.2.5)
nvbnvbnbvnvbn YEAR:

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1.1 VBNVHNB VNVBNVBNBVN

2. Emergency lighting does not comply with required lux levels

3. Emergency lighting not being activated within 15 seconds.

4. Emergency lighting will not last long enough to ensure safe

evacuation of indoor workplaces. (minimum 20 minutes)

5. Emergency lighting is not kept in good and clean working order

or tested for efficient operation

1ST QUARTER 2ND QUARTER 3RD QUARTER 4TH QUARTER

NO. nvbnvhgjhmm
Check Action Check Action Check Action Check Action

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DATE OF INSPECTION

INSPECTOR'S SIGNATURE

SPOT-CHECK / AUDIT
(Date and initials)