Home EV Charging Station Assessment Sheet

Client Information

Name Address Phone / Email

Vehicle Information

Make & Model Battery Capacity (kWh) Charging Port Type

Existing Electrical Service

Main Service Panel Amperage Available Circuit Breaker Slots Location of Main Panel Distance from Panel to Parking Area (m)

Desired Charging Station

Preferred Charger Type Level 1 (120V) Level 2 (240V) Desired Location for Charger Mounting Surface

Installation Site Assessment

Item	Yes / No	Notes
Accessible Parking Spot
Weather Protection Needed
Space for Charger Installation
Existing Conduit/Pathway Available

Additional Notes / Observations