Arc Flash Risk Assessment Checklist Form
Evaluate arc flash risk at your worksite or equipment location with this concise, modern checklist.
Worksite or Equipment Location
*
Equipment Type
*
Please Select
Switchgear
Panelboard
Motor Control Center
Transformer
Other
Voltage Rating (Volts)
*
Presence of Arc Flash Warning Label
*
Yes
No
Personal Protective Equipment (PPE) Compliance
*
Compliant
Not Compliant
Not Applicable
Last Maintenance Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Barriers or Covers in Place
*
Yes
No
Not Applicable
Observed Risk Level
*
Please Select
Low
Moderate
High
Severe
Recommended Corrective Actions / Observations
Assessor Name
*
Submit Assessment
Should be Empty: