MEIWC {BS7671}

All fields must be completed before this certificate is forwarded to the Qualifying Supervisor for quality checks

Customer Name

Select date
Job Number

Details of Departures from BS 7671

Site Address
Auto location or manual below

Description of Minor Works

Details of the Modified Circuit

System type and earthing arrangements

Protective measures against electric shock

Over current device for the modified circuit BS (EN)

RCD type


Details of wiring system to modify the circuit.

Cable type
Reference method

Reference method comments

CSA of Lives. mm2
CSA of CPC mm2

Where the measure for protection against electric shock is ADS, insert maximum disconection time permitted by BS7671.

Max Zs permitted by BS7671. In Ohms

Comments on this Instalation

Inspection and Testing Results

Confirmation that necessary inspections undertaken

Circuit resistance R1+R2 or R2 Ohms

Resistance measurement

Insulation resistance M,Ohms





Instrument serial No.

Conformation of the adequacy of earthing

Conformation of the adequacy of protective bonding

Confirmation of polarity

Max measured earth fault loop impedance Zs. Ohms
RCD operating times @ I🔼n in m/sec

Pass / Fail

RCD operating times @ 5x I🔼n in m/sec

Pass / Fail

Agreed limitations, if any, on the inspection & testing

I certify that the electrical installation,to the extent that is effected by the electrical work,has been tested to ensure it is electrically safe and is accordance with the requirements of BS7671:2008 as amended and any other standard applying to the electrical installation under legislation.
Signature of Inspecting Person


This certificate must be checked by a Qualified Supervisor

For and on Behalf of
Cofely Technical Services
Belthorn House, Walker Park
Blackburn. BB1 2QE

NICEIC No. 022660 Branch No.015

Checked by Qualifying Supervisor
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.