Monaco Electric - Field Report

1 Job & Technician Info

Complete

Report Date *

Report date is required

Technician Name *

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Project *

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Job Number *

Job number is required

Arrival Time *

Departure Time *

Total Hours Worked:

2 Safety & Site Assessment

Complete

Safety Checklist

PPE worn?

Yes No

Lockout/Tagout performed?

Yes No

Arc Flash assessment done?

Yes No

Safety Follow-up Required *

Hazards Observed *

Weather *

Temperature (F)

Crew Size *

3 Work Performed

Complete

Work Type *

Please Specify *

Detailed Description *

/ 1000

Work description is required

Issues/Delays Encountered

4 Materials Used

Complete

Description	Qty	Unit Cost	Total

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Grand Total:

5 Photos, Notes & Sign-off

Complete

Photos

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Additional Notes

Customer Name *

Customer name is required

Customer Satisfaction

Customer Signature *

Safety Incidents Occurred

Incident Details *

6 Feeder Conduit Length Takeoff Form

PM ONLY

Row #	FROM	TO	TRUE TAPE NUMBERS BUSHING TO BUSHING		LENGTHS - PM ONLY
Row #	FROM	TO	Start	Finish	CONDUIT	MAKEUP	TOTAL LENGTH
1
2
3
4
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12
GRAND TOTALS:					0	0	0

Prepared By:

Date:

Verified By (PM):

Date:

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