OJEDA BUSINESS VENTURES, LLC

THIS FORM EXPIRES 90 DAYS AFTER THE INSPECTION DATED BELOW PER 29CFR1926.404(b)(1)(iii)(E)(4).

EQUIPMENT ID#: _____________________ DATE: ___/___/___

ELECTRICAL INSPECTION FORM

The following electrical equipment checks shall be made by visual/physical inspection testing
before use or on new to worksite issue equipment.

No Description √ or X
or N/A

1.0 Disconnect all equipment and connections from the power

source prior to the inspection.

2.0 Check that the equipment is free from external damage.

3.0 Visually check the cords, plugs, outlet sockets and other accessories for obvious damage:

 Discoloration (may indicate exposure to heat, chemical or moisture

 Cuts, abrasions, twists in the outer sheath of the cord (may be small or deep cuts
that expose the insulation of the inner cores)

 Electrical tape or other foreign objects attached to the cord (may indicate a break
or cut underneath)

 Damage to the insulation on the pin plugs (if applicable)

4.0 Physically check;

 Run the flexible cords through the hand to detect any twisting of the inner cores or
damage to the outer sheath

 Lightly wiggle pin plugs and other connections to ensure they are not loose.

 Flexible cords are effectively anchored to equipment, plugs and cord extension
sockets

 Extension leads – connect the plugs/sockets of the lead together to check that the
terminals have not spread.

5.0 Check where applicable:

 Operating controls are in good working order (secure, aligned and appropriately
identified

 Covers, guards and the like are secured in the manner intended by the
manufacturer or supplier

 Ventilation inlets and exhausts on electrical equipment are unobstructed

 Power boards (EPODs) – maximum load warning is intact and easy to read

INSPECTED BY: _______________________ HID: ____________ DATE: ___/___/___

Version 1.2.
THIS WORKSHEET MEETS ALL REQUIREMENTS WITH 29CFR126.404(b)(1)(i), OSHA’S REQUIREMENT TO
HAVE AN EMPLOYER BASED GROUND FAULT PROTECTION PROGRAM.

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