DOMESTIC ELECTRICAL INSTALLATION PERIODIC INSPECTION REPORT (FOR A SINGLE DWELLING)

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DOMESTIC ELECTRICAL INSTALLATION PERIODIC INSPECTION REPORT (FOR A SINGLE DWELLING) Issued in accordance with British Standard 7671 Requirements for Electrical Installations by an Approved Contractor or Conforming Body enrolled with the National Inspection Council for Electrical Installation Contracting, Vintage House, 37 Albert Embankment, London SE1 7UJ. A DETAILS OF THE CLIENT Client / Address: B ADDRESS AND DETAILS OF THE INSTALLATION Address: For explanatory notes relating to NICEIC software endorsement, see Notes for Recipients This report is not valid if the serial number has been defaced or altered DPN1/ Estimated age of the electrical installation: years Evidence of alterations or additions: If yes, estimated age: years Date of previous inspection: Records of installation available: Electrical Installation Certificate number or previous Periodic Inspection Report number: Records held by: Original (To the person ordering the work) C PURPOSE OF THE REPORT Purpose for which this report is required: D EXTENT OF THE INSTALLATION AND LIMITATIONS OF THE INSPECTION AND TESTING (see note below) (see note below) Extent of the electrical installation covered by this report: Agreed limitations, if any, on the inspection and testing: E PARTICULARS OF THE APPROVED CONTRACTOR Trading Title: Address: F 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 (see B), having exercised reasonable skill and care when carrying out the inspection and testing, hereby declare that the information in this report, including the observations (see G) and the attached schedules (see K and L), provides an accurate assessment of the condition of the electrical installation taking into account the stated extent of the installation and the limitations of the inspection and testing (see D). I/We further declare that in my/our judgement, the said installation was overall in condition (see H) at the time the inspection was carried out, and that it should be further inspected as recommended (see I). (Insert a satisfactory or an unsatisfactory, as appropriate) INSPECTION, TESTING AND ASSESSMENT BY: REPORT REVIEWED AND CONFIRMED BY: *See note below Signature: Signature: Postcode Name: (CAPITALS) Position: Name: (CAPITALS) (Registered Qualified Supervisor for the Approved Contractor at E) NICEIC Enrolment No (Essential information) Branch No: (if applicable) Date: Date: This Domestic Periodic Inspection Report must be used only for reporting on the condition of an existing installation. The inspection and testing have been carried out in accordance with BS 7671: 2001, as amended. Cables concealed within trunking and conduits, or and conduits concealed under floors, in inaccessible roof spaces and generally within the fabric of the building or underground, have not been visually inspected. * This Domestic Periodic Inspection Report should be reviewed and confirmed by the registered Qualified Supervisor of the Approved Contractor responsible for issuing it. This form is based on the model Periodic Inspection Report shown in Appendix 6 of BS 7671: 2001. Published by the National Inspection Council for Electrical Installation Contracting Copyright NICEIC (Dec 2002) Please see the Notes for Recipients on the reverse of this page. Page 1 of

NOTES FOR RECIPIENT THIS REPORT IS AN IMPORTANT AND VALUABLE DOCUMENT WHICH SHOULD BE RETAINED FOR FUTURE REFERENCE The purpose of periodic inspection is to determine, so far as is reasonably practicable, whether an electrical installation is in a satisfactory condition for continued service. This report provides an assessment of the condition of the electrical installation identified overleaf at the time it was inspected, taking into account the stated extent of the installation and the limitations of the inspection and testing. The report has been issued in accordance with the national standard for the safety of electrical installations, British Standard 7671: 2001 (as amended) - Requirements for Electrical Installations (formerly known as the IEE Wiring Regulations). If you were the person ordering the work, but not the user of the installation, you should pass this report, or a full copy of it including these notes, the schedules and additional pages (if any), immediately to the user. The Original report form should be retained in a safe place and shown to any person inspecting or undertaking further work on the electrical installation in the future. If you later vacate the property, this report will provide the new user with an assessment of the condition of the electrical installation at the time the periodic inspection was carried out. Where the installation incorporates a residual current device (RCD), there should be a notice at or near the main switchboard or consumer unit stating that the device should be tested at quarterly intervals. For safety reasons, it is important that you carry out the test regularly. Also for safety reasons, the electrical installation will need to be re-inspected at appropriate intervals by a competent person. The recommended maximum time interval to the next inspection is stated on page 2 in Section I (Next Inspection). The NICEIC* recommends that you engage the services of an Approved Contractor for this purpose. There should be a notice at or near the main switchboard or consumer unit indicating when the next inspection of the installation is due. Only an NICEIC Approved Contractor or Conforming Body is authorised to issue this NICEIC Domestic Electrical Installation Periodic Inspection Report form. The report consists of at least three numbered pages. Additional numbered pages may have been provided to permit further relevant information concerning the installation to be recorded. The report is invalid if any of the identified pages are missing. The report has a printed seven-digit serial number, which is traceable to the Approved Contractor to which it was supplied by the NICEIC. This report is intended to be issued only for the purpose of reporting on the condition of an existing electrical installation. The report should identify, so far as is reasonably practicable and having regard to the extent and limitations recorded in Section D, any damage, deterioration, defects, dangerous conditions and any non-compliances with the requirements of the national standard for the safety of electrical installations which may give rise to danger. It should be noted that the greater the limitations applying to a report, the less its value. This report should not have been issued to certify that a new electrical installation complies with the requirements of the national safety standard. A Domestic Electrical Installation Certificate or Electrical Installation Certificate should be issued for the certification of a new installation. You should have received the report marked Original and the Approved Contractor should have retained the report marked Duplicate. Section D addresses the extent and limitations of the report by providing boxes for the Extent of the electrical installation covered by this report and the Agreed limitations, if any, on the inspection and testing. Information given here should fully identify the scope of the inspection and testing and of the report. The Approved Contractor should have agreed all such aspects with the person ordering the work and other interested parties (eg insurance company, landlord, mortgagee etc) before the inspection was carried out. A declaration of the overall condition of the installation should have been given by the inspector in Section F of the report. The declaration must reflect that given in Section H, which summarises the observations and recommendations made in Section G. A list of observations and recommendations for urgent remedial work and corrective action(s) necessary to maintain the installation in a safe working order should have been given in Section G, where appropriate. For further guidance on the recommendations, please see the reverse of page 2. Should the person ordering the periodic inspection (eg the client, as identified on Page 1 of this report) have reason to believe that the report issued by the Approved Contractor does not reasonably reflect the condition of the electrical installation reported on, the person should in the first instance raise the specific concerns in writing with the Approved Contractor. If the concerns remain unresolved, the client may make a formal complaint to the NICEIC, for which purpose a standard complaint form is available on request. The complaints procedure offered by the NICEIC is subject to certain terms and conditions, full details of which are available upon application and from the website. The NICEIC does not investigate complaints relating to the operational performance of electrical installations (such as lighting levels), or to contractual or commercial issues (such as time or cost). *The NICEIC (National Inspection Council for Electrical Installation Contracting) is an independent consumer safety body set up to protect users of electricity against the hazards of unsafe and unsound electrical installations. It is the industry s voluntary electrical safety regulatory body. It is not a trade association. The NICEIC Approved Contractor scheme has been accredited by the United Kingdom Accreditation Service (UKAS) against the requirements of EN 45011 - General requirements for bodies operating product certification systems. NICEIC Approved Contractors have been assessed as having the technical capability to carry out electrical work in compliance with the national standard for the safety of electrical installations, British Standard 7671 - Requirements for Electrical Installations (formerly the IEE Wiring Regulations), and all electrical installation work carried out by them is required to comply with that standard. For more further information about electrical safety and how the NICEIC can help you, visit www.niceic.org.uk Continued on the reverse of page 3

G OBSERVATIONS AND RECOMMENDATIONS FOR ACTIONS TO BE TAKEN Referring to the attached schedules of inspection and test results, and subject to the limitations at D: There are no items adversely affecting electrical safety. or The following observations and recommendations are made. Item No 1 Code This report is not valid if the serial number has been defaced or altered DPN1/ H SUMMARY OF THE INSPECTION General condition of the installation: Original (To the person ordering the work) Note: If necessary, continue on additional page(s), which must be identified by the Domestic Periodic Inspection Report serial number and page number(s). Date(s) of the inspection: Overall assessment of the installation: (Entry should read either Satisfactory or Unsatisfactory ) Note: If necessary, continue on additional pages(s), which must be identified by the Domestic Periodic Inspection Report serial number and page number(s). Where observations are made, the inspector will have entered one of the following codes against each observation to indicate the action (if any) recommended:- 1. 3. requires urgent attention or requires further investigation or 2. 4. requires improvement or does not comply with BS 7671: 2001 (as amended) Please see the reverse of this page for guidance regarding the recommendations. Urgent remedial work recommended for Items: Corrective action(s) recommended for Items: I NEXT INSPECTION I/We recommend that this installation is further inspected and tested after an interval of not more than: (Enter interval in terms of years or months, as appropriate) provided that any items at G which have been attributed a Recommendation Code 1 (requires urgent attention) are remedied without delay. Items which have been attributed a Recommendation Code 2 or 3 should be actioned as soon as practicable (see G). J SUPPLY CHARACTERISTICS, EARTHING AND BONDING ARRANGEMENTS Enter details, as appropriate Supply Characteristics System Type(s) Characteristics of Primary Supply Main Switch or Circuit-Breaker Nominal Overcurrent Protective Device(s) V voltage: U (1) Nominal frequency, f (1) Prospective fault (2) current, I pf External earth fault (3) loop impedance, Z e Notes: (1) by enquiry (2) by enquiry or by measurement (3) by measurement Hz ka Ω TN-S TN-C-S TT BS(EN) Type Nominal current rating Short-circuit capacity A ka Type: BS(EN) No of Poles Supply material Supply csa mm 2 Voltage rating Current rating, I n RCD operating current, I n * RCD operating time (at I n ) * V A ma ms * (applicable only where an RCD is used as a main circuit-breaker) Means of Earthing Distributor s facility: Installation earth electrode: Type: (eg rod(s), tape etc) Electrode resistance, R A : Location: Method of measurement: (Ω) Main Protective s Earthing conductor Main equipotential bonding material csa mm 2 material csa mm 2 Continuity check ( ) Continuity check ( ) Water service Oil service Bonding of extraneous-conductive-parts ( ) Gas service Structural steel Lightning protection Other incoming service(s) This form is based on the model Periodic Inspection Report shown in Appendix 6 of BS 7671: 2001. Published by the National Inspection Council for Electrical Installation Contracting Copyright NICEIC (Dec 2002) Please see the Notes for Recipients on the reverse of this page. Page 2 of

GUIDANCE FOR RECIPIENTS ON THE RECOMMENDATION CODES Only one Recommendation Code should have been given for each recorded observation. Recommendation Code 1 Where an observation has been given a Recommendation Code 1 (requires urgent attention), the safety of those using the installation may be at risk. The person responsible for the maintenance of the installation is advised to take action without delay to remedy the observed deficiency in the installation, or to take other appropriate action (such as switching off and isolating the affected part(s) of the installation) to remove the potential danger. The NICEIC Approved Contractor issuing this report will be able to provide further advice. It is important to note that the recommendation given at Section I Next Inspection of this report for the maximum interval until the next inspection is conditional upon all items which have been given a Recommendation Code 1 being remedied without delay (see Section G). Recommendation Code 2 Recommendation Code 2 (requires improvement) indicates that, whilst the safety of those using the installation may not be at immediate risk, remedial action should be taken as soon as possible to improve the safety of the installation to the level provided by the national standard for the safety of electrical installations, BS 7671. The NICEIC Approved Contractor issuing this report will be able to provide further advice. Items which have been given a Recommendation Code 2 should be remedied as soon as possible (see Section G). Recommendation Code 3 Where an observation has been given a Recommendation Code 3 (requires further investigation), the inspection has revealed an apparent deficiency which could not, due to the extent or limitations of this inspection, be fully identified. Items which have been given a Recommendation Code 3 should be investigated as soon as possible (see Section G). The person responsible for the maintenance of the installation is advised to arrange for the NICEIC Approved Contractor issuing this report (or other competent person) to undertake further examination of the installation to determine the nature and extent of the apparent deficiency. Recommendation Code 4 Recommendation Code 4 [does not comply with BS 7671: 2001 (as amended)] will have been given to observed non-compliance(s) with the current safety standard which do not warrant one of the other Recommendation Codes. It is not intended to imply that the electrical installation inspected is unsafe, but careful consideration should be given to the benefits of improving these aspects of the installation. The NICEIC Approved Contractor issuing this report will be able to provide further advice.

Circuit number K SCHEDULE OF ITEMS INSPECTED Methods of protection against electric shock Insulation of live parts, and barriers or enclosures Presence of RCD(s) for supplementary protection against direct contact and/or protection against indirect contact Presence of earthing conductor and circuit protective Presence of main equipotential bonding Presence of supplementary equipotential bonding Class II fixed equipment SELV L SCHEDULE OF ITEMS TESTED External earth fault loop impedance, Z e Installation earth electrode resistance, R A M CIRCUIT DETAILS 1 2 3 4 5 6 7 8 9 10 11 12 Circuit designation Type of wiring (see code) Reference method (see Appendix 4 of BS 7671) See note below See note below Number of points served Prevention of mutual detrimental influence Identification Circuit : csa Live cpc (mm 2 ) (mm 2 ) Proximity of non-electrical services and other influences Segregation of Band I and Band II circuits or Band II insulation used Electrical separation Presence of diagrams, instructions, circuit charts and similar information Presence of danger notices Presence of other warning notices Continuity of protective Continuity of ring final circuit Max. disconnection time permitted by BS 7671 For explanatory notes relating to NICEIC software endorsement, see Notes for Recipients Overcurrent protective devices BS (EN) Type No Rating Short-Circuit capacity (s) (A) (ka) RCD Operating current, I n (ma) Identification (cont) Labelling of protective devices, switches and terminals Maximum Z s permitted by BS 7671 (Ω) Identification of Cables and Routing of in prescribed zones or within mechanical protection Connection of Erection methods Selection of for current carrying capacity and voltage drop Presence of fire barriers, suitable seals and protection against thermal effects Insulation resistance between live Insulation resistance between live and earth Polarity N TEST RESULTS Circuit impedances (Ω) This report is not valid if the serial number has been defaced or altered General DPN1/ SCHEDULES Presence and correct location of appropriate devices for isolation and switching Adequacy of access to switchgear and other equipment Particular protective measures for special installations and locations Connection of single-pole devices for protection or switching in phase only Correct connection of accessories and equipment Choice and setting of protective and monitoring devices (for protection against indirect contact and/or overcurrent) Selection of equipment and protective measures appropriate to external influences Selection of appropriate functional switching devices Earth fault loop impedance, Z s Operation of residual current device(s) Functional testing of assemblies Insulation resistance Polarity Ring final circuits only (measured end to end) r n All circuits (At least one column to be completed) Phase/Neutral Phase/Earth Neutral/Earth r 1 (Phase) (Neutral) r 2 (cpc) R 1 + R 2 R 2 ( ) Maximum measured earth fault loop impedance, Z s RCD operating times at I n at 5 I n (if applicable) (MΩ) (MΩ) (MΩ) (Ω) (ms) (ms) CODES FOR TYPE OF WIRING A B C D E F G H O (Other - please state) Original (To the person ordering the work) Mineralinsulated XLPE/SWA PVC/SWA in non-metallic trunking in metallic trunking in non-metallic conduit in metallic conduit PVC/PVC Continuity Insulation resistance Test instruments (serial numbers) used: Earth fault loop impedance RCD Earth electrode resistance All boxes must be completed. indicates that an inspection or a test was carried out and that the result was satisfactory. X indicates that an inspection or a test was carried out and that the result was unsatisfactory. N/A indicates that an inspection or a test was not applicable to the particular installation. LIM indicates that, exceptionally, a limitation agreed with the person ordering the work (as recorded in Section D) prevented the inspection or test being carried out. This form is based on the model Periodic Inspection Report shown in Appendix 6 of BS 7671: 2001. Published by the National Inspection Council for Electrical Installation Contracting Copyright NICEIC (Dec 2002) Page 3 of

NOTES FOR RECIPIENT (continued from the reverse of page 1) Irrespective of the method of compilation of the form, all unshaded boxes should have been completed either by insertion of the relevant details or by entering N/A, meaning Not Applicable, where appropriate. Where the information provided in this report has been checked, compiled and printed with the aid of a proprietary software package endorsed by the NICEIC, a computer-printed copy of the NICEIC logo will appear in the box at the top left-hand corner of the front page of the report and on the schedule(s) of test results, together with an indication of the supplier of the software and the software version number. NICEIC-endorsed software embodies a system of checking the completeness and acceptability of the inspection and test results, but it remains the responsibility of the compiler of the report to ensure that the information provided on the report is factual, and that the declaration (in Section F) of the overall condition of the electrical installation to which the report relates is reasonable in all the circumstances. If no computer-printed copy of the NICEIC logo appears in the boxes, the technical information provided on the report has not been subjected to the automatic checks endorsed by the NICEIC. December 2002