‫الــفـــريــــق الســتــشــــارات الســـالمــــة‬

TEAM SAFETY CONSULTANTS L.L.C

Client Name : ________________________ Instruments: Job No. : _______________
Location : ________________________ PAT Tester: ___________ Type : ___________ Date of Test : _______________

PORTABLE APPLIANCE TEST REPORT

Bond Test Insulation Load Touch CT Leakage
Item Serial No. / Appliance
Visual RPE RISO ILN PLN IPE ITC ISL Remarks
No. I.D. No Description     
(Ω) (MΩ) (Amp) (VA) (mA) (mA) (mA)

Name and Position of person who Note:  - OK,  - Not OK

carried out the inspection

______________________
Inspection Engineer

TEAM SAFETY CONSULTANTS L.L.C, TRADE LICENSE NO. 500714, AL-GARHOUD, P. O. BOX: 112349, DUBAI -UAE,
TEL: 04-2828868,FAX: 04-2865265 EMAIL: info@tsc-uae.ae, WEBSITE: https://www.tsc-uae.ae/

TSC-F-91F (Rev.05) (22/01/2023) Page 1 of 1