Security Beacon Inspection Checklist Form
Complete this checklist to document the inspection and operational status of security beacons.
Beacon ID or Location
*
Date and Time of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Inspector Full Name
*
First Name
Last Name
Inspection Type
*
Routine
Follow-up
Emergency
Physical Condition of Beacon
*
Excellent
Good
Fair
Poor
Operational Status
*
Fully operational
Partially operational
Not operational
Checklist: Beacon Components Inspected
*
Power supply
Signal light
Mounting hardware
Control panel
Wiring
Other
Beacon Performance Rating
*
1
2
3
4
5
Issues Found
Corrective Actions Taken
Additional Comments or Observations
Submit Inspection
Should be Empty: