212262 (2) a 1 .1Z�
LOCATION / 2.DAT RCD,% 3.TIME RCD.
4,READY AM 1 1 A4)TINEA., 1 S.TYPE OF 6-A EA 7. INSPT.MADE
PM 1 I SPECIFY JNS_CT. TIME
e:�c---m✓ DATE _
6-APPROVED1 1
DISAPPROVE 1 9.REMARKS
INSPECTOR e—
• Tr-
280-671
WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE
ITEMIZE THE FOLLOWING New Old
Outlets -, Panels, Cabinets Size Service Conduit
Switches 2 Switchboards Size Service Wires
7
�Recepfacles J5 Panelboards Size Service Switch
!Fixtures 9- Festoon Lamps Size Sub Feed Conduit
Mercury Lamps Dryer KW Size Sub Feed Wires
Ranges KW Heaters KW- Number of Circuits
Signs Transformer Motors Number of Meters
HP Phase Ampere Loadsl2�LighNng Power
Miscellaneous
Rough Inspection 8:29- By
Final Inspection By
Remarks:
I
280-201n