ELECTRICAL INSTALLATION CONDITION REPORT

"This report is not valid if the serial number has been defaced or altered"
"Issued in accordance with BS 7671:2018 - Requirements for Electrical Installations"

PART 1 - DETAILS OF THE CONTRACTOR, CLIENT AND INSTALLATION

DETAILS OF THE CONTRACTOR

Registration No: Branch No: Trading Title: Address: Postcode: Tel No:

DETAILS OF THE CLIENT

Contractor Reference Number (CRN): Name: Address: Postcode: Tel No:

DETAILS OF THE INSTALLATION

Occupier: Address: Postcode: Tel No:

PART 2 - PURPOSE OF THE REPORT

Purpose for which this report is required: Date(s) when inspection and testing was carried out: Records available: Previous inspection report available: Previous report date:

PART 3 - SUMMARY OF THE CONDITION OF THE INSTALLATION

General condition of the installation (in terms of electrical safety): Estimated age of electrical installation (years): Evidence of additions or alterations: Overall assessment of the installation is:

PART 4 - DECLARATION

I, being the person responsible for the inspection and testing of the electrical installation, particulars of which are described in PART 7, hereby CERTIFY that the information in this report, including the observations and the attached schedules, provides an accurate assessment...

Name (capitals): Signature: Date:

Reviewed By - Registered Qualified Supervisor Name (capitals): Signature: Date:

ELECTRICAL INSTALLATION CONDITION REPORT

"This report is not valid if the serial number has been defaced or altered"

PART 5 - NEXT INSPECTION

Recommended interval (years/months): Reason for recommendation:

PART 6 - OBSERVATIONS AND RECOMMENDATIONS FOR ACTIONS TO BE TAKEN

For each observation, indicate: '✓' if Acceptable; 'N/A' if Not Applicable; 'LIM' if a Limitation exists; or use codes: CODE C1, C2, C3 or FI.

Item No	Observation(s)	Code	Location Reference

(Additional rows as required)

Immediate action required for items: Improvement recommended for items: Urgent remedial action required for items: Further investigation required for items:

ELECTRICAL INSTALLATION CONDITION REPORT

"This report is not valid if the serial number has been defaced or altered"

PART 7 - DETAILS AND LIMITATIONS OF THE INSPECTION AND TESTING

Details of the installation covered by this report: Agreed limitations on the inspection and testing (if any): Extent of sampling: Operational limitations including reasons: Agreed with (print name):

PART 8 - SUPPLY CHARACTERISTICS AND EARTHING ARRANGEMENTS

System Type and Earthing Arrangements: Nominal line voltage, U (V): Nominal line voltage to Earth, U0 (V): Nominal frequency, f (Hz): Prospective fault current, Ipf (kA): External loop impedance, Ze (Ω):

PART 9 - PARTICULARS OF INSTALLATION REFERRED TO IN THIS REPORT

Means of Earthing - Distributor's facility: Installation earth electrode: Main protective conductors - Earthing conductor (material and size):

ELECTRICAL INSTALLATION CONDITION REPORT

"This report is not valid if the serial number has been defaced or altered"

PART 10 - SCHEDULE OF ITEMS INSPECTED

List the items inspected (enter details or mark with ✓, N/A, LIM, or appropriate CODE):

Additional notes / next inspection recommendations:

ELECTRICAL INSTALLATION CONDITION REPORT

"This report is not valid if the serial number has been defaced or altered"

PART 11 - SCHEDULES AND ADDITIONAL PAGES

Schedule of Inspections (Page No(s)): Schedule of Circuit Details & Test Results (Page No(s)): Additional sources / Special installations (Page No(s)):

"The pages identified are an essential part of this report (see Regulation 653.2)"

ELECTRICAL INSTALLATION CONDITION REPORT

"This report is not valid if the serial number has been defaced or altered"

PART 12 - SCHEDULE OF CIRCUIT DETAILS AND TEST RESULTS

Enter details for each circuit. Use the following codes for wiring type:

A: Thermoplastic insulated / sheathed cable, B: Thermoplastic in metallic conduit, C: Thermoplastic in non-metallic conduit, etc.

Circuit No.	Description	Wiring Code	Points Served	Conductor (mm²)	Live	CPC	Max. Demand (A)	Protective device (Type & Rating)	RCD (IΔn, mA)	Max. Zs (Ω)

DISTRIBUTION BOARD (DB) DETAILS

DB designation: Location of DB:

TEST INSTRUMENTS

Multi-function (Serial No): Continuity: Insulation resistance: Earth fault loop impedance: Earth electrode resistance: RCD (if applicable):

"This report is based on the model forms shown in Appendix 6 of BS 7671"