ELECTRICAL INSTALLATION CONDITION REPORT

1 D. EXTENT AND LIMITATIONS OF INSPECTION AND TESTINGE xtent of the ELECTRICAL INSTALLATION covered by this reportAgreed limitations including the reasons, see Regulation agreed withOptional limitations, including the reasons, on page The inspection and testing detailed in this REPORT and accompanying schedules have been carried out in accordance with BS 7671:2008 as amended to It should be noted that cables concealed within trunking and conduits, under floors, in roof spaces, and generally within the fabric of the building or underground, have not been inspected unless specifically agreed between the client and inspector prior to the DETAILS OF THE INSTALLATION WHICH IS THE SUBJECT OF THIS REPORTO ccupierAddressDescription of premises:DomesticCommercialIndustrialOth er, please specify:Estimated age of the wiring of additions or alterationsNoYesNot ApparentInstallation records available?

2 Yes, estimated ageDate of last inspectionB. REASON FOR PRODUCING THIS REPORTDate(s) on which the inspection and testing was carried out:AddressNameA. DETAILS OF THE CLIENT OR PERSON ORDERING THE WORKThis REPORT is based on the model shown in BS 7671 : 2008 amended to 2011 PageofAlternative source of supply (as detailed on attached schedule)E. SUMMARY OF THE CONDITION OF THE INSTALLATIONG eneral CONDITION of the INSTALLATION (in terms of ELECTRICAL safety)Overall assessment of the of the INSTALLATION in terms of its suitability for continued use :*An unsatisfactory assessment indicates that dangerous and/or potentially dangerous conditions have been INSTALLATION CONDITION REPORTREPORT NUMBER:ORIGINAL REPORTThis REPORT is based on the model shown in BS 7671 : 2008 amended to 2011 PageofDatePositionSignatureName (CAPITALS) REPORT AUTHORISED FOR ISSUE BY:G.

3 DECLARATIONI/We, being the person(s) responsible for the inspection and testing of the ELECTRICAL INSTALLATION (as indicated by my/our signatures below), particulars of which are described above, having exercised reasonable skill and care when carrying out the inspection and testing, hereby declare that the information in this REPORT , including the observations and the attached schedules, provides an accurate assessment of the CONDITION of the ELECTRICAL INSTALLATION taking into account the stated extent and limitations in section D of this RECOMMENDATIONSW here the overall assessment of the suitability of the INSTALLATION for continued use above is stated as UNSATISFACTORY, I / we recommend that any observations classified as Danger present (Code C1) or Potentially dangerous (Code C2)

4 Are acted upon as a matter of urgency Investigation without delay is recommended for observations identified as Requiring further investigation Observations classified as Improvement recommended (Code C3) should be given due to the necessary remedial action being taken, I / we recommend that the INSTALLATION is further inspected and tested byEarthing ConductorConductor MaterialConductor csaContinuity Check( )Main protective bonding conductors( )Continuity CheckConductor csaConductor MaterialBonding of extraneous conductive partsWaterGasOilStructural steelOtherK. MAIN PROTECTIVE CONDUCTORSC onductor csaSupply ConductorNo. of polesType BS (EN)Rated current InVoltage ratingRCD Operating Time RCD Operating Current L.

5 MAIN SWITCH/SWITCH-FUSE/CIRCUIT BREAKER/RCDL ocation of the earth electrode Electrode resistance RA TypeJ. PARTICULARS OF THE INSTALLATION REFERRED TO IN THIS REPORTM eans of earthingDistributors facilityIInstallation earth electrodeH. SCHEDULES schedule(s) of inspection and schedule(s) of test results attached schedule(s) are part of this document and this REPORT is valid only when they are attached to SUPPLY CHARACTERISICS AND EARTHING ARRANGEMENTSTN-C-STTTN-SSystem TypeNumber and type of live phase (2 wire)2 phase (3 wire)3 phase (3 wire)2 poleOther3 phase (4 wire)3 pole1 phase (3 wire)Nature of Supply ParametersNominal voltage U(1)Nominal frequency f(1)PFC Ipf(1,2)Earth fault loop impedance Ze(1,2)VoltsHzkA Characteristics of primary overcurrent protective deviceBS (EN)TypeRated currentShort circuit capacityDatePositionSignatureName (CAPITALS)INSPECTED AND TESTED BY.

6 ELECTRICAL INSTALLATION CONDITION REPORTREPORT NUMBER:ORIGINAL REPORTM. OBSERVATIONSR eferring to the attached schedules of inspection and test results, and subject to the limitations specified at the Extent and Limitations of the Inspection and testing sectionNo remedial action is requiredThe following observations are madeThis REPORT is based on the model shown in BS 7671 : 2008 amended to 2011 PageofOne of the following codes, as appropriate, has been allocated to each of the observations made above to indicate to the person(s) responsible for the INSTALLATION the degree of urgency for remedial - Potentially dangerous - urgent remedial action requiredC3 Improvement recommendedC1 - Danger present.

7 Risk of injury. Immediate remedial action requiredAdditional observation pagesPage number(s) ELECTRICAL INSTALLATION CONDITION REPORTREPORT NUMBER:ORIGINAL REPORTSCHEDULE OF CIRCUIT DETAILS FOR THE INSTALLATIONL ocation of the distribution boardDistribution board designationTO BE COMPLETED IN EVERY CASEP hase rotation confirmed (where applicable)TO BE COMPLETED ONLY IF THE DISTRIBUTION BOARD IS NOT CONNECTED DIRECTLY TO THE ORIGIN OF THE INSTALLATIONS upply to the board is fromNo. of phasesNominal voltageAssociated RCD (if any) BS (EN)Overcurrent protective device for the distribution boardType BS (EN)RatingRCD No. of polesI nCIRCUIT DETAILSC ircuit number and phaseCircuit descriptionType of wiring (see code below)Reference methodNumber of points servedCircuit conductors csaLinecpcmm2mm2 Maximum permitted disconnection timeSOvercurrent protective device(s)BS (EN) TypeRatingShort circuit capacityAkARCDO perating current I nmAMax.

8 Zs permitted by BS 7671 CODES FOR TYPE OF WIRINGAPVC/PVC cablesPVC cables in metallic conduitBPVC cables in non-metallic conduitCPVC cables in metallic trunkingDPVC cables in non-metallic trumkingEPVC/SWA cablesFXLPE/SWA cablesGMICCHO (other) please specifyThis REPORT is based on the model shown in BS 7671 : 2008 amended to 2011 PageofELECTRICAL INSTALLATION CONDITION REPORTREPORT NUMBER:ORIGINAL REPORTSCHEDULE OF TEST RESULTS FOR THE INSTALLATIONTest instruments usedEarth fault loop impedanceInsulation resistanceContinuityRCDMFTO thereTO BE COMPLETED ONLY IF THE DISTRIBUTION BOARD IS NOT CONNECTED DIRECTLY TO THE ORIGIN OF THE INSTALLATIONC onfirmation of supply polarityZsIpfOperating time of associated RCD (if any)At I nAt 5 nCircuit number and phaseCircuit impedances ( )Ring final circuits only (measured end to end)All circuits (at least 1 column to be completed)r1R1 + R2r2rnR2 Insulation resistance Live/ LiveLive/ NeutralLive/ EarthNeutral/ EarthZsPolarity RCD Operating timesAt I nAt 5 nmSmSM M M M TEST RESULTSS ignatureName (CAPITALS)

9 Date of TestingTESTED BY:This REPORT is based on the model shown in BS 7671 : 2008 amended to 2011 PageofELECTRICAL INSTALLATION CONDITION REPORTREPORT NUMBER:ORIGINAL REPORTN. INSPECTION SCHEDULE FOR A SINGLE DISTRIBUTION BOARD INSTALLATIONITEMDESCRIPTIONOUTCOMEF urther investigation required?OUTCOMESA cceptable CONDITION Unacceptable CONDITION state C1 or C2 Improvement recommended state C3 Not Verified NVLimitation LIMNot Applicable AND ADEQUACY OF DISTRIBUTORS OR SUPPLY INTAKES ervice tails - tails - of addequate arrangements for secondary or alternative sources such as microgeneration ( , ) AND BONDING ARRANGEMENTS ( , Chapter 54) of distributors earthing arrangement ( , ) of earth electrode where applicable ( ) of earthing or bonding labels at all appropriate locations ( ) of earthing conductor size ( , ) of earthing conductor connections ( ) of main protective bonding conductor sizes ( )

10 Of main protective bonding conductor connections ( , ) of all protective bonding connections ( ) UNIT OR DISTRIBUTION of working space or accessibility to the consumer unit or distribution board ( , ) of fixing ( ) of enclosure(s) in terms of IP rating etc ( ) of enclosure(s) in terms of fire rating etc ( ) not damaged or deteriorated so as to impair safety ( iii) of linked main switch as required by by , of main switch - functional check ( ) operation of circuit breakers and RCDs to prove disconnection ( ) of schedule of circuit details at or near the consumer unit or distribution board ( ) of RCD retest notice at or near the consumer unit or distribution board ( ) of mixed cable colour warning notice at or near the consumer unit or distribution board ( ) of dual supply warning notice at or near the consumer unit ( ) of other required labelling - specify below (514) REPORT is based on the model shown in BS 7671 : 2008 amended to 2011 PageofELECTRICAL INSTALLATION CONDITION REPORTREPORT NUMBER:ORIGINAL REPORTN.