EMERGENCY LIGHTING COMPLETION CERTIFICATE

1 EMERGENCY LIGHTING COMPLETION CERTIFICATEFor new installations and verification of existing installationsCertificate Reference:DETAILS OF THE CLIENTDETAILS OF THE EMERGENCY LIGHTING INSTALLATIONDETAILS OF THE ELECTRICAL CONTRACTORDECLARATION OF CONFORMITYDETAILS OF DEVIATIONS FROM THE STANDARDRELATED REFERENCE DOCUMENTSNEXT INSPECTIONC lient:Address:InstallationAddress:Extent of theinstallation coveredby this CERTIFICATE :The Installation is:NewAn additionAn alterationTrading Title:Address:Registration Number:Telephone Number:In consequence of acceptance of the declarations on Forms 2, 3, and 4 I/we hereby declare that the EMERGENCY LIGHTING installation,as described above, conforms, to the best of my/our knowledge and belief to the appropriate recommendations and requirements given in BS 5266-1: 2005 EMERGENCY LIGHTING Part 1: Code of practice for the EMERGENCY LIGHTING premises, BS EN 1838: 1999 / BS5266-7: 1999 LIGHTING applications - EMERGENCY LIGHTING and BS EN 50172: 2004 / BS 5266-8: 2004 EMERGENCY escape LIGHTING systems, as set out in the declarations Forms 2, 3, and 4, except for the deviations listed :Position.

2 Signature:Date:This CERTIFICATE is not valid unless accompanied by current versions of the following:i) Signed declaration(s) Forms 2, 3, and 4 ii) Photometric design data (see Note 3) iii) Log bookEssential related reference documents:I/We, the designer, RECOMMEND that this installation is further inspected and tested after an interval of not more than:Enter interval in accordance with Clause of BS EN 50172: 2004 / BS 5266-8: 2004 Notes: 1. The electrical safety aspects of the EMERGENCY LIGHTING installation must also be certified in accordance with BS 7671 Requirements for Electrical Installations by issuing an Electrical Installation CERTIFICATE or, where appropriate, a Minor Electrical Installation Works Where this CERTIFICATE relates to a major alteration or addition, it should be accompanied by an EMERGENCY LIGHTING Periodic Inspection and Testing CERTIFICATE for the entire EMERGENCY LIGHTING This can be any of the following formats (in all cases appropriate de-rating factors must be used)

3 , and identified to meet the worst case requirements: a) Authenticated spacing date such as ICEL 1001 registered tables. b) calculations as detailed in CBSE / SLL Guide LG12. c) appropriate computer printof :This form is based on the model shown in Annex C of BS 5266: Part 1: 2005 Page: 1 of 4 Declaration (Design, Installation or Verification)Requirement NoDetails of deviation (If necessary record additional deviations on a separate sheet)You created this PDF from an application that is not licensed to print to novaPDF printer ( ) EMERGENCY LIGHTING DESIGN DECLARATIONFor new installations and verification of existing installationsDETAILS OF THE CLIENTDETAILS OF THE EMERGENCY LIGHTING INSTALLATIONDETAILS OF THE ELECTRICAL CONTRACTOR RESPONSIBLE FOR THE DESIGNDESIGN CONFORMITY DECLARATIONDETAILS OF DEVIATIONS FROM THE CODE OF PRACTICE (BS 5266 -1: 2005)DESIGNC lient:Installation Address.

4 Extent of theinstallation coveredby this CERTIFICATE :The Installation is:NewAn additionAn alterationTrading Title:Address:Registration Number:Telephone Number:I/We hereby declare that the EMERGENCY LIGHTING installation, as described above, has been DESIGNED by me/us and, to the best ofmy/our knowledge and belief, the design complies with the relevant recommendations given in BS 5266 EMERGENCY LIGHTING Part 1:2005 Code of practice for EMERGENCY LIGHTING , BS EN 1838: 1999 / BS 5266-7: 1999 LIGHTING applications - EMERGENCY LIGHTING , and BS EN 50172: 2004 / BS 5266-8 EMERGENCY escape LIGHTING :Position:Signature:Date:Postcode:This form is based on the model shown in Annex C of BS 5266: Part 1: 2005 Reference: _____ Page: 2 of 4BS 5266-1clausereferenceRequirementsYesNoSy stem Accurate plans available showing escape routes, fire alarm control panel, call points and fire Fire safety signs in accordance with BS 5499-4 and -5, clearly visible and adequately The luminaires conform to BS EN Luminaries located at the following positions.

5 A) At each exit door intended to be used in an EMERGENCY b) Near stairs so each tread receives direct light, and near any other level change c) Near mandatory EMERGENCY exits and safety signs d) At each change of direction and at intersections of corridors e) Outside and near to each final exit f) Near each first aid post g) Near fire fighting equipment and call points (NOTE: Near means within 2m horizontally) At least two luminaires illuminating each compartment of the escape routeD6- Additional EMERGENCY LIGHTING provided where needed to a) Lift b) Moving stairways and c) Toilet facilities larger than 8 m2 floor area or without borrowed light, and those for disabled d) Motor generator, control and e) Covered car Design duration adequate for the Operation and maintenance instructions and a suitable log book produced for retention anduse by the building Illuminance, Escape routes for any use: 1lx min.

6 (on the centre line) areas above 60 m2: lx min. (anywhere in the core area)Requirement NoDetails of deviation (If necessary record additional deviations on a separate sheet)You created this PDF from an application that is not licensed to print to novaPDF printer ( ) EMERGENCY LIGHTING CONSTRUCTION DECLARATIONFor new installations and verification of existing installationsDETAILS OF THE CLIENTDETAILS OF THE EMERGENCY LIGHTING INSTALLATIONDETAILS OF THE ELECTRICAL CONTRACTOR RESPONSIBLE FOR THE CONSTRUCTIONCONSTRUCTION CONFORMITY DECLARATIONDETAILS OF DEVIATIONS FROM THE CODE OF PRACTICE (BS 5266 -1: 2005)CONSTRUCTIONC lient:Address:InstallationAddress.

7 Extent of theinstallation coveredby this CERTIFICATE :The Installation is:NewAn additionAn alterationTrading Title:Address:Registration Number:Telephone Number:I/We hereby declare that the EMERGENCY LIGHTING installation, as described above, has been CONSTRUCTED by me/us and, to the best of my/our knowledge and belief, the design complies with the relevant recommendations given in BS 5266 EMERGENCY LightingPart 1: 2005 Code of practice for EMERGENCY LIGHTING , BS EN 1838: 1999 / BS 5266-7: 1999 LIGHTING applications - EMERGENCY LIGHTING , and BS EN 50172: 2004 / BS 5266-8 EMERGENCY escape LIGHTING :Position:Signature:Date:Postcode:This form is based on the model shown in Annex C of BS 5266: Part 1: 2005 Reference: _____ Page.

8 3 of 4BS 5266-1clausereferenceRequirementsYesNoSy stem The system installed conforms to the agreed All non-maintained luminaires fed or controlled by the final circuit supply of the local normal mains Luminaires mounted at least 2m above the Luminaires mounted at a suitable height to avoid being located in smoke reservoirs or other likely area of smoke Fire safety signs in accordance with BS 5499-4 and -5, clearly visible and adequately The wiring of central power systems has adequate fire protection and is appropriately Output voltage range of the central power system is compatible with the supply voltage range of the luminaries, taking into account supply cable voltage No glow starters in any EMERGENCY LIGHTING circuits (see BS EN 60598-2-22)

9 All plugs and sockets protected against unauthorised The system has suitable and appropriate testing facilities for the specific The equipment manufacturers' installation and commissioning procedures satisfactorily The installation conforms to BS 7671 Requirement NoDetails of deviation (If necessary record additional deviations on a separate sheet)You created this PDF from an application that is not licensed to print to novaPDF printer ( ) EMERGENCY LIGHTING VERIFICATION DECLARATIONFor new installations and verification of existing installationsDETAILS OF THE CLIENTDETAILS OF THE EMERGENCY LIGHTING INSTALLATIONDETAILS OF THE ELECTRICAL CONTRACTOR RESPONSIBLE FOR THE VERIFICATIONVERIFICATION CONFORMITY DECLARATIONTEST INSTRUMENTS USEDDETAILS OF DEVIATIONS FROM THE CODE OF PRACTICE (BS 5266 -1: 2005)VERIFICATIONC lient:Installation Address:Extent of theinstallation coveredby this CERTIFICATE :The Installation is:NewAn additionAn alterationTrading Title:Address:Registration Number:Telephone Number:Instrument 1 (Light Meter) Model:Serial Number.

10 Instrument 2 (If Any) Model:Serial Number:I/We hereby declare that the EMERGENCY LIGHTING installation, as described above, has been VERIFIED by me/us and, to the best of my/our knowledge and belief, the design complies with the relevant recommendations given in BS 5266 EMERGENCY LIGHTING Part 1:2005 Code of practice for EMERGENCY LIGHTING , BS EN 1838: 1999 / BS 5266-7: 1999 LIGHTING applications - EMERGENCY LIGHTING , and BS EN 50172: 2004 / BS 5266-8 EMERGENCY escape LIGHTING systemsName:Position:Signature:Date:Post code:This form is based on the model shown in Annex C of BS 5266: Part 1: 2005 Reference: _____ Page: 4 of 4BS 5266-1clausereferenceRequirementsYesNoSy stem Plans available and System has a suitable test facility for the All escape route safety signs and fire fighting equipment location signs visible with the normal LIGHTING Luminaires correctly positioned and oriented as shown