Sample Electrical Installation Condition Report Form

SECTION A: DETAIlS Of ThE ClIENT / pErSON OrDErINg ThE rEpOrT

Name .......................................................................................................... Address ..........................................................................................................

................................................................................................................................................................................................................................................

SECTION C: DETAIlS Of ThE INSTAllATION whICh IS ThE SubjECT Of ThIS rEpOrT

Occupier ................................................................................................................................................................................................................................

Address ................................................................................................................................................................................................................................

Description of premises (tick as appropriate)

Domestic Commercial Industrial Other (include brief description) ...................................................................................

Estimated age of wiring system ................................... years

Evidence of additions / alterations Yes

No Not apparent If yes, estimate age ................................... years

Installation records available? (Regulation 621.1) Yes

No Date of last inspection ................................... (date)

SECTION g: DEClArATION

I/we being the person(s) responsible for the inspection and testing of the electrical installation (as indicated by my/our signatures below), particulars of which

are described above, having exercised reasonable skill and care when carrying out the inspection and testing, hereby declare that the information in this report,

including the observations and the attached schedules, provides an accurate assessment of the condition of the electrical installation taking into account the

stated extent and limitations in Section D of this report.

Inspected and tested by:

Name (CApITAlS): ................................................................................

Signature: ...............................................................................................

for/on behalf of: ....................................................................................

position: .................................................................................................

Address: ..................................................................................................

....................................................................... Date: ..............................

SECTION b: rEASON fOr prODuCINg ThIS rEpOrT

Date(s) on which inspection and testing was carried out ......................................................................................................................................................

SECTION D: ExTENT AND lImITATIONS Of INSpECTION AND TESTINg

Extent of electrical installation covered by this report ............................................................................................................................................................

Agreed limitations including the reasons (see Regulation 634.2) ..........................................................................................................................................

Agreed with: ...........................................................................................................................................................................................................................

Operational limitations including the reasons (see page no. ............ ) ..................................................................................................................................

The inspection and testing detailed in this report and accompanying schedules have been carried out in accordance with BS 7671:2008 (IET Wiring Regulations) as amended to ............................

It should be noted that cables concealed within trunking and conduits, under oors, in roof spaces and generally within the fabric of the building or underground, have NOT been inspected unless

specically agreed between the client and inspector prior to inspection.

SECTION E: SummAry Of ThE CONDITION Of ThE INSTAllATION

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

Overall assessment of the installation in terms of its suitability for continued use SATISfACTOry / uNSATISfACTOry * (delete as appropriate).

* An unsatisfactory assessment indicates that dangerous (code C1) and/or potentially dangerous (code C2) conditions have been identied.

SECTION f: rECOmmENDATIONS

Where the overall assessment of the suitability of the installation for continued use above is stated as UNSATISFACTORY, I/we recommend that any observations

classed as ‘Danger present’ (code C1) or ‘Potentially dangerous’ (code C2) are acted upon as a matter of urgency. Investigation without delay is recommended for

observations identied as ‘Further investigation required’. Observations classied as ‘Improvements recommended’ (code C3) should be given due consideration.

Subject to the necessary remedial action being taken, I/we recommend that the installation is further inspected and tested by ................................... (date).

report authorised for issue by:

Name (CApITAlS): ................................................................................

Signature: ...............................................................................................

for/on behalf of: ....................................................................................

position: .................................................................................................

Address: ..................................................................................................

....................................................................... Date: ..............................

SECTION h: SChEDulE(S)

................................... schedule(s) of inspection and ................................... schedule(s) of test results are attached. The attached schedule(s) are part of this document

and this report is valid only when they are attached to it.

C-EICR5 REV V1 Aug 2011

ElECTrICAl INSTAllATION CONDITION