Lightning Protection System Inspection Form

General Information

Site/Building Name Address Inspection Date Inspector Name

System Details

System Type Installed Date Previous Inspection Date

Inspection Checklist

Item	Condition	Comments
Main Conductor	Good Fair Poor N/A
Air Terminals (Rods)	Good Fair Poor N/A
Connections/Clamps	Good Fair Poor N/A
Earth Terminations	Good Fair Poor N/A
Surge Protectors	Good Fair Poor N/A

Additional Notes

Inspector's Signature

Date