Test Report Form V1.0

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Customer and Site Details

• Client Name:

• Address:

Switchboard Details

• Switchboard Location:

• Switchboard / Distribution board:

• Main Earth Location:

• Main Earth Viewed:

  Yes

  No

  N/A

• Job Reference No:

• MEN Link Viewed:

  Yes

  No

  N/A

Electrical Work Details

• Description:

• Visual Inspection Complete

  Yes

  No

• Circuit Number:

• Neutral Number:

• Phase:

  Select Red White Blue

  • Red
  • White
  • Blue

• Number of Items:

• Circuit Protection Size:

• Cable Size:

  Select .75mm 1mm 1.5mm 2.5mm 4mm 6mm 10mm 16mm 25mm 35mm 50mm 70mm 90mm 120mm

  • .75mm
  • 1mm
  • 1.5mm
  • 2.5mm
  • 4mm
  • 6mm
  • 10mm
  • 16mm
  • 25mm
  • 35mm
  • 50mm
  • 70mm
  • 90mm
  • 120mm

• Cable Type:

• Continuity Test:

• Insulation Resistance:

• Polarity Test:

• Fault Loop Impedance:

• Operation Test:

  Yes

  No

  N/A

• RCD Test:

Completion

• Electrical Contractor Licence Number: 11404

• Tested By:

• Electrical Licence Number:

• I certify that the electrical installation listed above, to the extent it is affected by the electrical work, has been tested to ensure it is electrically safe and is in accordance with the requirements of AS/NZ 3000:2007 and any other standard applying under the Electrical Safety Regulation 2002 to to the electrical installation.

• Test Date:

• Signature:

  Sign

• Job Complete:

  Yes

  No