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Run: NETA Thermographic Infrared Survey Report

Use this NETA Thermographic Infrared Survey Report template to document electrical hot spots, scan conditions, delta-T findings, and corrective priorities in...

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Survey Identification

Survey date and time recorded

Facility, building, and area identified

Record the site name, building, room, and specific electrical area surveyed.

Inspector name and qualifications documented

Identify the thermography technician or competent person performing the survey.

Survey scope and equipment list defined

Select all equipment types included in the survey.

Note (optional)

Scan Conditions and Safety Controls

Equipment was scanned under normal operating load critical (required)

Confirm the equipment was energized and operating under representative load at the time of the scan.

Yes No N/A

Load condition at time of scan recorded critical (required)

Enter the measured or estimated load percentage at the time of the infrared scan.

Note (optional)

Ambient conditions recorded

Document ambient temperature, weather or room conditions, and any factors affecting the scan.

Electrical safety controls verified critical (required)

Select all safety controls in place during the survey.

Note (optional)

Scan limitations or obstructions noted

Identify whether covers, insulation, reflections, distance, or access limitations affected image quality or interpretation.

Yes No N/A

Thermographic Findings

Asset or component identification critical (required)

Record the exact equipment and component location, such as feeder breaker, lug, termination, or bus connection.

Thermal anomaly observed

Indicate whether a hot spot, abnormal temperature rise, or other thermal irregularity was observed.

Yes No N/A

Delta-T classification assigned critical (required)

Classify the temperature differential severity for the observed condition.

Note (optional)

Measured temperature or delta-T value

Enter the measured temperature, temperature rise, or delta-T value associated with the anomaly.

Note (optional)

Thermal image captured critical (required)

Attach the infrared image showing the anomaly or representative scan image.

Visible-light reference photo captured

Attach a corresponding visible-light photo identifying the equipment and location.

Condition Assessment and Priority

Condition assessed for immediate risk critical (required)

Select the assessed condition based on observed severity and operational risk.

Note (optional)

Corrective priority assigned

Assign the repair priority for work planning and follow-up.

Note (optional)

Recommended corrective action documented critical (required)

Describe the recommended repair, adjustment, cleaning, tightening, replacement, or further investigation.

Follow-up inspection date assigned

Enter the planned date and time for re-scan or verification after corrective action.

Closeout and Sign-Off

All findings reviewed with site representative

Confirm the survey results and priorities were communicated to the responsible site contact.

Yes No N/A

Exceptions, access issues, or missed assets documented

Record any equipment that could not be scanned, any access restrictions, or any exceptions to the survey scope.

Inspector signature critical (required)

Report approved by supervisor or responsible manager

Confirm review and approval by the responsible supervisor, manager, or AHJ representative if applicable.

Yes No N/A

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