Lighting System Monitoring Checklist
Please complete this checklist to monitor and record the status of your lighting system.
Location of Lighting System
*
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Overall System Status
*
Operational
Partially Operational
Non-Operational
Number of Lights Not Functioning
*
Are all emergency lights operational?
*
Yes
No
N/A
Are all light fixtures securely mounted?
*
Yes
No
Is there any visible damage to wiring or fixtures?
*
Yes
No
Are all control switches functioning properly?
*
Yes
No
N/A
Additional Notes or Observations
Submit Checklist
Should be Empty: