ELECTRICAL INSTALLATION AUDIT – REPORT

1 Reference No: ELECTRICAL INSTALLATION AUDIT REPORT Page 1 of 9 Latest issue: December 2020 DETAILSC ustomer: Status: Address: Phone: Home: Mobile: B. ADDRESS OF THE INSTALLATION TO BE AUDITEDA ddress: estimated age (years ): Estimated age of the ELECTRICAL INSTALLATION (years): Evidence of alterations or additions: Date of previous AUDIT : (if any) C. PURPOSE OF THE REPORTP urpose for which this REPORT is requested: D. EXTENT OF THE INSTALLATION AND LIMITATIONS OF THE INSPECTION AND TESTINGE xtent of the ELECTRICAL INSTALLATION and agreed limitations, if any, on the inspection and testing: Additional comments: Phone: , b eing the person responsible for the AUDIT of t he ELECTRICAL INSTALLATION (as indicated by my signature below), particulars of w hich are described abov e (se e B), havi ng exercised reasonable skill and car e when carrying out the AUDIT , hereby declare that the information in this REPORT , including the observations (s ee G), provides an accurate assessment of t he condition of the ELECTRICAL INSTALLATION taking into account the stated extent of the AUDIT and the limitations of t he visual inspection and testing (see D).

2 I further declare that in my judgment, the condition of the said INSTALLATION was at the time the AUDIT was carried out. This does not preclude the possibility that other defects may exist. , TESTING AND ASSESSMENT BY:Name:CompanyLicence number:Date of AUDIT : This ELECTRICAL INSTALLATION AUDIT REPORT is not a substitute for a Certificate of ELECTRICAL Safety and cannot be relied on as part of certification of a Certificate of ELECTRICAL Safety. See page 9 for customer No: ELECTRICAL INSTALLATION AUDIT REPORT Page 2 of 9 Latest issue: December 2020 G. OBSERVATIONS AND RECOMMENDATIONS FOR ANY ACTIONS TO BE TAKENThe following observations and recommendations are made: Reference No: ELECTRICAL INSTALLATION AUDIT REPORT Page 3 of 9 Latest issue: December 2020 PART 1 - SUPPLY AND SWITCHBOARD A: Supply Mains A1. Power company equipment B4. Circuit interconnection (crossed wiring) Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below A2 Consumers mains Phases 1 2 3 B5.

3 Circuit protection (Sizes) Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below A3. Meter enclosureB6. Main Earth Adequate and satisfactory Satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below B: Switchboard B1. Location and Accessibility B6. Main Earth Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below B2. Fire resistance B7. Safety Switch/esAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Installed on all Socket outlet circuits Installed on all lighting circuits Installed on all fixed equipment circuitsOther: Comments: Item No.

4 Item No. Item No. Item No. Item No. Item No. Item No. B3. Switchboard EnclosureAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowB8. Safety Switch/esAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowNot installedReference No: ELECTRICAL INSTALLATION AUDIT REPORT PART 2 - Distribution boardsC1: Supply Submain Phases 1 2 3C6. Circuit interconnection (crossed wiring) Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below C2 Switchboard C7. Circuit protection (Sizes)Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See belowUNSAFE Urgent action required See below C3. Switchboard Enclosure C8.

5 Earthing System Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Installed on all Socket outlet circuits Installed on all lighting circuits Installed on all fixed equipment circuits Other: C4. Fire resistanceC11. Other:Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowC5. Location and AccessibilityAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Comments: Item N o . Item No. Item No. Item No. Item No . Item No. Item No . Page 4 of 9 Latest issue: December 2020 C10. Safety Switch/esC9. Safety switchesNot installedC12. Other:Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowReference No: ELECTRICAL INSTALLATION AUDIT REPORT Page 5 of 9 Latest issue: December 2020 PART 3 - WIRING AND ACCESSORIES F: Wiring F1.

6 Power Circuits F7. Light Fittings Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowF2. Lighting Circuits F8. Light Switch/esAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowF9. Smoke alarm/detectorAdequate and satisfactory Satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below F11. Emergency LightingAdequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below Comments: Item No.

7 Item N o. Item N o. Item No. Item No. Item N o. Item N o. F6. Socket OutletsF12. OtherF10. Carbon Monoxide alarm Not installed Not installedAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowAdequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowF3. Cooking Circuit Not installedF4. Hot Water Circuit Not installedF5. Air Conditioning Circuit Not installedReference No: ELECTRICAL INSTALLATION AUDIT REPORT Page of 9 Latest issue: December 2020 PART 4 FIXED ELECTRICAL APPLIANCES Note: Fix ed appliances are c hecked where electricity supply is av ailable and for basic operation only. No d etailed technical testing is perform ed on appliances K: Appliances K1. Oven Not applicable Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below K2.

8 Hot plates Not applicable Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below K3. Hot Water system Not applicable Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent acti on required Se e below K4. Dishwasher Not applicable K9. Other: Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below K5. Range hood K10. Other: Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below Comments: Item No.

9 Item No. Item No. Item No. Item No. Item No. Item No. Not applicableK6. Exhaust fans Not applicableK7. Air conditioning unit Not applicableK8. Ceiling fans Not applicableReference No: ELECTRICAL INSTALLATION AUDIT REPORT Page 7 of 9 Latest issue: December 2020 PART 5 SUPPLEMENTARY/STANDBY ENERGY SUPPLY S: Generator Supply Type: S1. Power company equipment S5. Inverter equipment Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See Generator Source Phases 1 2 3 Not Applicable S6. Location and Accessibility Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See below Adequate and satisfactory Attention recommended See below UNSAFE Urgent acti on required Se e below S3. Generator mains S7.

10 Switchboard connections Adequate and satisfactory Satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below S4. Isolation facilities S9. Other: Adequate and satisfactory Adequate and satisfactory Attention recommended See below Attention recommended See below UNSAFE Urgent action required See below UNSAFE Urgent action required See below Comments: Item No. Item N o. Item No. Item No. Item No. Item No. Item No. Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowS8. Battery Energy Storage SystemS10. Other:Adequate and satisfactory Attention recommended See below UNSAFE Urgent action required See belowReference No: ELECTRICAL INSTALLATION AUDIT REPORT Page 8 of 9 Latest issue: December 2020 Test Results obtained Notes Pass/Fail Main Earth conductor Equipotential bonding Subcircuit protective earths Submain Earth systemReference No: Page 9 of 9 Latest issue: December 2020 AUDIT REPORT The purpose of this ELECTRICAL INSTALLATION AUDIT REPORT is to determine, so far as is reasonably practicable, whether an ELECTRICAL INSTALLATION is in a satisfactory condition for continued service.