Overcurrent Protection Checklist
Comprehensive inspection and assessment form for overcurrent protection devices and systems.
Inspector Full Name
*
First Name
Last Name
Inspector Email Address
*
example@example.com
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Site/Facility Name
*
Location/Area Inspected
*
Equipment/Panel Identification
*
Overcurrent Protection Device Details
*
Rows
Device Type
Device Rating (A)
Manufacturer/Model
Condition
Device 1
Circuit Breaker
Fuse
Other
Good
Needs Attention
Replace
Device 2
Circuit Breaker
Fuse
Other
Good
Needs Attention
Replace
Device 3
Circuit Breaker
Fuse
Other
Good
Needs Attention
Replace
Checklist: Please assess the following aspects for the overcurrent protection devices.
*
Rows
Compliant
Non-Compliant
Not Applicable
Correct device type installed
1
2
3
Device rating matches application
4
5
6
Device is properly labeled
7
8
9
No visible damage or defects
10
11
12
Device is accessible for inspection
13
14
15
Coordination with upstream/downstream devices
16
17
18
Manufacturer's instructions followed
19
20
21
Overall Compliance Rating
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Additional Observations or Comments
Inspector Signature
*
Submit Checklist
Submit Checklist
Should be Empty: