Electrical Safety Inspection Electrical Safety Inspection Step 1 of 5 20% Date MM slash DD slash YYYY Inspected ByLeightonIsGayAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Property DetailsType of PropertyResidentialCommercialIndustrialOtherProperty UsageDomestic DwellingHotel / Motel / HostelDormitories & Shared HousingOther Property Usage Property UsageWarehousingFactoryProperty UsageRetail / ShopfrontOfficesEducationalHealthcareDwelling TypeSeperate Dwelling - Single LevelSeparate Dwelling - Multi LevelAttached Dwelling - Single LevelAttached Dwelling - Multi LevelotherOther Dwelling Electrical Supply SystemPower SourceGrid SupplyIndependent SupplyMains Parallel Generation - No Battery BackupMains Parallel Generation - With Battery BackupMains Parallel Generation - Non-Grid - No Battery BackupMains Parallel Generation - Non-Grid - Battery BackupMains Parallel Generation - Backup Generator with ChangeoverOtherOther Power Grid Supply TypeN/A230V Men System - Single Phase400V Men System - Polyphase400V Men System - 3 Phase400V Men System - 3 Phase | On-Site TransformerOtherOther Grid Point of SupplyN/APoletopPlinthPitOnsite Fuses (within boundary)Not Readily IdentifiableOtherOther Grid Point of Supply Image(s)Max. file size: 15 MB. Service Line TypeUndergroundOverheadOtherOther Service Line Service Line Cable TypeFabric / Cloth Covered Copper in steep conduitTough Rubber SheathMultiple TPS CopperMulticore XLPE CopperMulticore XLPE CopperMulticore Aluminum (including AI to CU tail-downs or LugsNeutral Screened CopperNeutral Screened AluminumSingle Core(s) CopperSingle Core (s) AlunminiumSingle Core(s) Copper ParallelSingle Core(s) Aluminum ParallelOtherOther Service Line Cable Type
