GFCI Monthly Test Log
Record and track monthly inspections of Ground Fault Circuit Interrupter (GFCI) outlets for safety compliance.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location/Area of GFCI Outlet
*
Outlet Identification Number or Label
*
Physical Condition of Outlet
*
Good
Damaged
Requires Attention
Test Result
*
Pass
Fail
If Failed, Describe Corrective Action Taken
Retest Date (if applicable)
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector's Name
*
First Name
Last Name
Additional Comments
Supervisor Review/Approval
Approved
Further Action Required
Signature of Inspector
*
Submit Log
Submit Log
Should be Empty: