Your Full Name (required)
Which Emergency Light are you inspecting? 12345678
Are the following satisfactory and in working order?
Is the Emergency Light visible with no obstructions YesNo
Is the Emergency Light in good condition with no damage? YesNo
Does the light illuminate immediately after losing mains power? YesNo
Keep the power off for 30 seconds, is the Emergency Light still illuminated? YesNo
If no to any questions explain below or if you have any additional comments or safety concerns?
This form will be stamped with the date and time at time of submission and will be stored on our secure servers for the purpose of traceability with regards to maintaining Emergency Lighting
By clicking submit, I confirm and acknowledge, I understand the legal importance of recording accurate information required for Health & Safety compliance purposes, and the submission of incorrect, false information could increase the risk of serious injury and could lead to disciplinary actions as appropriate.
By clicking submit. I have confirmed the details entered above are correct at the time of inspection.
Submitted forms are automatically sent to The Factory Managers for actioning.
