Fixed Appliance Electrical Safety Verification Sheet
General Information
Project / Site
Location
Date
Appliance Description
Manufacturer
Model No.
Serial No.
Visual Inspection
Check
Pass
Fail
Comments
Appliance securely fixed
Free from damage/defects
Correctly fused/isolated
Cables free from damage
Earthing satisfactory
Test Results
Test
Measured Value
Pass
Fail
Comments
Earth Continuity
Insulation Resistance
Polarity Check
Comments / Additional Observations
Tested By (Name & Signature)
Date