Emergency Lighting Inspection Form Template

SAFETY & COMPLIANCE INSPECTION

Emergency Lighting Inspection Form

Record emergency lighting equipment conditions, test results, and any corrective actions required.

Business / Property Name *

Contact Number *

Site Address *

Building / Floor / Area

Inspection Reference

Inspector Full Name *

Inspection Date *

Start Time *

End Time *

Inspection Type *

Light / Fixture ID *

Fixture Location *

Make / Manufacturer

Model Number

Type of Emergency Lighting *

Select one result for each inspection item.

Inspection Item	Pass	Fail	N/A
Fixture securely mounted
Housing and lens undamaged
Indicator / charging light operating
Emergency light activates during test
Light output visually satisfactory
Exit sign visible and unobstructed
Equipment restores normal operation

Test Duration (Minutes)

Required Duration (Minutes)

Battery Test Result *

Were any defects identified? *

Yes No

Inspection Photos / Evidence Optional: Attach photos of fixtures, defects or test results.

Overall Inspection Outcome *

Additional Comments

Recommended Next Inspection Date

Inspector Signature (Typed Name) *

I confirm that this inspection record accurately reflects the checks and tests performed. *