High-Intensity Discharge Light Inspection Form
Please complete this form to document the inspection of HID light fixtures. Accurate and thorough reporting ensures safety and optimal performance.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Location / Site
*
Fixture Identification Number
*
Type of HID Fixture
*
Please Select
Metal Halide
High-Pressure Sodium
Low-Pressure Sodium
Mercury Vapor
Other
Fixture Operational Status
*
Operating Normally
Not Operating
Intermittent
Condition Ratings
*
Rows
Good
Fair
Poor
Bulb/Lamp
1
2
3
Ballast
4
5
6
Wiring
7
8
9
Reflector
10
11
12
Lens/Cover
13
14
15
Test Results (if applicable)
Corrective Actions or Recommendations
Upload Photo(s) of Fixture (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional Comments
Inspector Signature
*
Submit Inspection
Submit Inspection
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