Title Page

  • Electrical Installation Certificate No.

  • Client

  • Location
  • Conducted on

  • Prepared by

  • Purpose for which this report is required

  • Date of last inspection and testing carried out

  • Previous periodic inspection or condition report no.

Details of Installation

  • Are the installation records available?

  • Description of premises

  • Estimated age of the electrical installation

Extent of the Installation and Limitations of the Inspection and testing

  • Extent of the electrical installation covered by this report

  • Agreed limitations (including the reasons), if any, on the inspection and testing

  • Operational limitations including the reasons

Summary of the condition of the installation

  • General condition of the installation (in terms of electrical safety)

  • Overall assessment of the installation

Documentation

  • Click + to add media information for documentation

  • Photo
  • Take a photo of any significant information (e.g. faulty wires, damaged equipment, etc)

  • Description

Completion

  • Reviewed and confirmed by (Full Name and Signature of Qualified Supervisor of the Approved Contractor)

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