PROJECT / DEPARTMENT NAME : __________________________

ELEMENT 1.2a
MONTHLY RECORD OF INSPECTING, REPORTING AND REPLACING DEAD LIGHTS

Area of Inspection Month of Inspection

Inspector Name Date of Inspection

RAISE THE ISSUES THROUGH CORRECTION REPORT (BEFORE & AFTER PHOTO) BELOW FOR ACTION TAKEN

Use the following key when reporting defective lights in the “DESCRIPTION" column:
1 = Dead 2 = Flickering 3 = Lamp cover broken/missing 4 = Switch faulty 5 = Lamp fitting damaged
Location (E.g Type of Light
Caravan/ Site Control room, Eng. (Néon Tube, Description Action Required
Office) Bulb)

Signed: ___________________________________
Inspector Date: _________________

Signed: ___________________________________
Dept. / Project Manager Date: __________________

BEFORE AFTER
Doc. no : El.1.2c Issue Date: 01.07.18 Rev. No . 01 Page 1 of 2
What Observed: Date : Correction Done: Date :

What Observed: Date : Correction Done: Date :

Doc. no : El.1.2c Issue Date: 01.07.18 Rev. No . 01 Page 2 of 2