Street Light Maintenance Checklist Form
Date of Inspection
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
First Name
Last Name
Location
Check below conditions for switches
Rows
Yes
No
Checked
1
2
Cleaned
3
4
Repaired
5
6
Additional Comments
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Check below conditions for circuit breakers
Rows
Yes
No
Checked
7
8
Cleaned
9
10
Repaired
11
12
Additional Comments
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Check below conditions for joints
Rows
Yes
No
Checked
13
14
Cleaned
15
16
Repaired
17
18
Additional Comments
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Check below conditions for PE Cell
Rows
Yes
No
Checked
19
20
Cleaned
21
22
Repaired
23
24
Additional Comments
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Check below conditions for Contractors
Rows
Yes
No
Checked
25
26
Cleaned
27
28
Repaired
29
30
Additional Comments
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Check below conditions for all lamps and control gear
Rows
Yes
No
Checked
31
32
Cleaned
33
34
Repaired
35
36
Additional Comments
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Inspector Signature
Submit
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