Sage Living EMF Intake Forms
Client info
Electric and Magnetic Field Overview
Exterior readings
Interior readings
Interior AC Fields
Breaker assessment
Tips
Summary
Net Current Summary
M.E.P. (ON)
Sub 1 (ON)
Sub 2 (ON)
M.E.P. (OFF)
Sub 1 (OFF)
Sub 2 (OFF)
MEP H1
MEP H2
MEP N
Sub 1 H1
Sub 1 H2
Sub 1 N
Sub 2 H1
Sub 2 H2
Sub 2 N
MEP H1
MEP H2
Diff (Y/N)?
Ground Rod (#1)
Ground Rod (#2)
UFER
Water Line
Water Line Ground
Gas Line
Telephone Line
Telephone Ground
Telephone Location
Cable Line
Cable Ground
Cable Location
House/Utility Grd vs
Separate Ground Rod (diff)
Electric / Magnetic Field Overview:
Net current at sub panel:
Yes
No
Bonding screw turned in:
Yes
No
Bonding strap or wire present connecting to neutral bus:
Yes
No
Equipment grounding conductors connected to the neutral bus:
Yes
No
only show this with any YES logic, or only show it on the tips page:
All of above should be NO and any presence of these could be cause of net current and be readily corrected at the panel.
Net current at main service drop:
Yes
No
only show this with YES logic:
How much
Net current on neutral in excess of phase sum:
Yes
No
only show this with logic:
Current present on ground electrode conductor to water line:
Yes
No
only show this with any YES logic:
Switch OFF power to determine if current still present.
Current still present:
Yes
No
if Yes:
only show this with any YES logic:
Current entering from neighbors (install dielectric coupling):
Yes
No
if No:
Current is being generated from within house - assess panel to identify net current pairs(s) or circuit(s) and trace same to locate cause.
Log assessment shown in breaker panel summary report.
Breaker assessment form
Next steps
Client info
Electric and Magnetic Field Overview
Exterior readings
Interior readings
Interior AC Fields
Breaker assessment
Tips
Summary