Emergency Lighting Log and Test Sheet Form

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Emergency Lighting Log and Test Sheet Form

Audit

Inspection Checklist

Inspection? Click "Add"

Device

Emergency Light Remote Head (Single) Remote Head (Dual) Exit Sign

Device Location

Unit Reference Number

Volts / Watts

Battery Date

Select date

Type of test

30-second test 90-minute test

Are all luminaires and other emergency lighting equipment in good working condition?

Yes No N/A

Are all lamps and fitting diffusers clean and undamaged?

Yes No N/A

Are all fittings work correctly?

Yes No N/A

Are all system healthy indicators on central battery systems illuminated?

Yes No N/A

Load Test

Pass Failed

Completion

Recommendations

Maintenance Inspector (Full Name and Signature)

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.