Title Page
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Electrical Installation Certificate No.
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Client
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Location
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Conducted on
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Prepared by
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Purpose for which this report is required
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Date of last inspection and testing carried out
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Previous periodic inspection or condition report no.
Details of Installation
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Are the installation records available?
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Description of premises
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Estimated age of the electrical installation
Extent of the Installation and Limitations of the Inspection and testing
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Extent of the electrical installation covered by this report
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Agreed limitations (including the reasons), if any, on the inspection and testing
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Operational limitations including the reasons
Summary of the condition of the installation
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General condition of the installation (in terms of electrical safety)
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Overall assessment of the installation
Documentation
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Click + to add media information for documentation
Photo
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Take a photo of any significant information (e.g. faulty wires, damaged equipment, etc)
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Description
Completion
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Reviewed and confirmed by (Full Name and Signature of Qualified Supervisor of the Approved Contractor)