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Original Certificate Certificate reference: …

Original CertificateCertificate reference : electrical installation CONDITION REPORT (Requirements for electrical Installations BS 7671 IEE Wiring Regulations)DETAILS OF THE CLIENTName:Address:PURPOSE FOR WHICH THIS REPORT IS REQUIREDThis report must be used only for reporting on the condition of an existing (s):DETAILS OF THE INSTALLATIONO ccupier:Address:Description of Premises:Domestic Commercial Industrial OtherEstimated age of the electrical installation :YearsEvidence of Alterations or Additions: If yes estimated age:YearsDate of previous Inspection: electrical installation Certificate No: or previous Periodic Inspection report No:Records of installation held by: EXTENT OF THE installation AND LIMITATIONS OF THE INSPECTION AND TESTINGE xtent of the electrical installation covered by this report:Agreed Limitations (including the reasons), if any, on the inspection and testingOperational limitations including the reasons (see page No.)

Original Certificate Certificate reference: ELECTRICAL INSTALLATION CONDITION REPORT (Requirements for Electrical Installations – BS 7671 IEE Wiring Regulations)

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