EICR Notes

• Document No.

• Client Name

• Client Address
  Address

• Different Site Address
• Site Address
  Address

• Date of Inspection

  Date

• Engineer

• V1.1 01/2017

• Any Observations Found?

  YES

  NO

• Observations

Observation

• Details of Observation

• Picture of Observation

  Media

• Classification

  Select C1 - Danger Present C2 - Potentially Dangerous C3 - Improvement Recommended Further Investigation Information Not Applicable

  • C1 - Danger Present
  • C2 - Potentially Dangerous
  • C3 - Improvement Recommended
  • Further Investigation
  • Information
  • Not Applicable

• Approximate Repair Cost

  Select Band A - £0-30 Band B - £30-50 Band C - £50-100 Band D - £100-250 Band E - £250+ Not Quantifiable Not Applicable

  • Band A - £0-30
  • Band B - £30-50
  • Band C - £50-100
  • Band D - £100-250
  • Band E - £250+
  • Not Quantifiable
  • Not Applicable

Labour

• LBD1 Applicable?

  YES

  NO

• LBD2

• LBD3

• Any out of hours work?

  YES

  NO

• LBC1 (Call Out Up To 3 Hours) Applicable?

  YES

  NO

• LBDOH1 (Out of Hours Rate 1) Applicable?

  YES

  NO

• LBDOH2 (Out of Hours Rate 2)

• LBDOH3 (Out of Hours Rate 3)

Materials

Supplied Materials

• Supplier

  KES

  WES

  TNR

  BFT

  Other

• Supplier

• Advice Note

Stock Materials

• Description

• Quantity

• Cost Each

Completion Checks

• Has the site been left safe and tidy?

  YES

  NO

• Details

• Engineer Sign

  Sign