ELECTRICAL INSTALLATION CERTIFICATE [BS 7671:2008 as amended] Details of of the the Installation. For Design. For Construction

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ELECTRICL INSTLLTION CERTIFICTE [BS 7671:008 as amended] Details of of the the Client Clien Client/ Details of of the the Installation : Extent of the stallation coveed by this cetificate The stallation is: New n ddition n lteation Fo Design I/We beg the peson(s) esponsible fo the design of the electical stallation (as dicated by my/ou signatue(s) below), paticulas of which ae descibed above, have execised easonable skill and cae when cayg out the design heeby CERTIFY that the design wok fo which I/We have been esponsible is, to the best of my/ou knowledge and belief accodance with BS 7671:008 amended to except fo the depatues, if any detailed as follows: Details of depatues fom BS 7671:008 as amended (Regulations 10.3, 10.4): The extent of liability of the signatoy o signatoies is limited to the wok descibed above as the subject of this cetificate. Fo the DESIGN of the stallation: Signatue Date Designe 1 Signatue Date Designe ** **(whee thee is mutual esponsibility fo the design) Fo Constuction I/We beg the peson(s) esponsible fo the constuction of the electical stallation (as dicated by my/ou signatue(s) below), paticulas of which ae descibed above, have execised easonable skill and cae when cayg out the constuction heeby CERTIFY that the constuction wok fo which I/We have been esponsible is, to the best of my/ou knowledge and belief accodance with BS 7671:008 amended to except fo the depatues, if any detailed as follows: Details of depatues fom BS 7671:008 as amended (Regulations 10.3, 10.4): The extent of liability of the signatoy is limited to the wok descibed above as the subject of this cetificate. Fo the CONSTRUCTION of the stallation: Signatue Date Constucto Fo Inspection and and Testg Testi I/We beg the peson(s) esponsible fo the spection and testg of the electical stallation (as dicated by my/ou signatue(s) below), paticulas of which ae descibed above, have execised easonable skill and cae when cayg out the spection and testg heeby CERTIFY that the wok fo which I/We have been esponsible is, to the best of my/ou knowledge and belief accodance with BS 7671:008 amended to except fo the depatues, if any detailed as follows: Details of depatues fom BS 7671:008 as amended (Regulations 10.3, 10.4): The extent of liability of the signatoy is limited to the wok descibed above as the subject of this cetificate. Fo the INSPECTION and TEST of the stallation: Signatue Date Inspecto Reviewed by Signatue Date Qualified Supeviso Page 1 of 5

Paticulas of the of the Signatoies to the to Electical the Electical Installation Installation Cetificate Ce DESIGNER (No 1) DESIGNER (No ) CONSTRUCTOR INSPECTOR Supply Chaacteistics and Eathg and Eathg angements ange System (s) Numbe and of Live Conductos Natue of Supply Paametes Supply potective device chaacteistics TN-S a.c. d.c. Nomal oltage U Uo TN-C-S TN-C TT 1-Phase ( wie) -Phase (3 wie) 3-Phase (3 wie) 1-Phase (3 wie) 3-Phase (4 wie) Pole 3 Pole Nomal fequency Pospective fault cuent Extenal loop impedence f lpf Ze Hz k Nomal cuent atg IT Numbe of Supplies Shot cicuit Capacity k Paticulas of Installation of Refeed Refeed to the to Cetificate the Ce Means of Eathg Distibuto's facility Installation eath electode Ma Switch o Cicuit-Beake (eg od(s), tape etc) Electode esistance,r Details of Installation Eath Electode (whee applicable) Maximum Demand (load ) Location Method of measuement Potective measue(s) agast electic shock No. of poles Supply Conductos mateial Supply Conductos CS mm oltage Ratg Cuent Ratg opeatg cuent, l n opeatg time at, l n Comments on on Existg Existg Installation Installat Next Inspection m csa: Eathg Conducto mateial: Contuity check mps/k Whee appopiate comments on the existg stallation ae to be found on page(s) Eathg and Potective Bondg Conductos Ma Potective bondg conductos mateial: mm csa mm Contuity check, The designe(s) RECOMMEND that this stallation is futhe spected and tested afte an teval of not moe than Bondg of extaneous conductive pats ( ) Wate Oil Lightng Gas Steel o change of tenancy Page of 5

Schedule of of Ite Ite Inspected Inspected PROTECTIE MESURES GINST ELECTRIC SHOCK Basic and fault potection SEL PEL Double o Refoced sulation Basic Potection Insulation of live pats Baies o enclosues Obstacles ** Placg out of each ** Fault potection utomatic disconnection of supply Pesence of eathg conducto Pevention of mutual detimental fluence Identification Poximity of non-electical sevices and othe fluences Segegation of Band I and Band II cicuits and Band II sulation used Segegation of safety cicuits Pesence of diaga, stuctions, cicuit chats and simila fomation Pesence of dange notices and othe wang notices Labellg of potective devices, switches and temals Identification of conductos Cables and conductos Selection of conductos fo cuent-cayg capacity and voltage dop Eection methods Pesence of cicuit potective conductos Pesence of ma potective bondg conductos Pesence of eathg aangements fo combed potective and functional puposes Pesence of adequate aangements fo altenate souces, whee applicable FEL Choice and settg of potective and monitog devices (fo fault potection and/o ovecuent potection) Non-conductg location ** bsence of potective conductos Eath-fee local equipotential bondg ** Electical Sepaation ddtional potection Pesence of eath-fee equipotential bondg Fo one item of cuent-usg equipment Fo moe than one item of cuent-usg equipment Pesence of esidual cuent device(s) Pesence of supplementay bondg conductos ** Fo use contolled supevised/conditions only Schedule of of Ite Ite Tested Tested Extenal eath fault loop impedence, Ze Installation eath electode esistance, R Contuity of potective conductos Contuity of g fal cicuit conductos Insulation esistance between live conductos + see note below Insulation esistance between live conductos and Eath Geneal Routg of pescibed zones Cables copoatg eathed amou o sheath, o un an eathed wig system, o othewise potected agast nails, scews and the like dditional potection by 30m fo concealed walls (whee equied, pemises not unde the supevison of skilled o stucted pesons) Connection of conductos Pesence of fie baies,suitable seals and potection agast themal effects Pesence and coect location of appopiate devices fo isolation and switchg dequacy of access to switchgea and othe equipment Paticula potective measues fo special stallations and locations Connection of sgle pole devices fo potection o switchg le conductos only Coect connection of accessoies and equipment Pesence of undevoltage potective devices Selection of equipment and potective measues appopiate to extenal fluences Selection of appopiate functional switchg devices Basic Potection by baie o enclosue povided dug eection Insulation of non-conductg floos and walls Polaity Eath fault loop impedance, Zs eification of phase sequence Opeation of esidual cuent devices Functional testg of assemblies Potection by sepaation of cicuits eification of voltage dop Schedule of of dditional Recods Recods [See attached [See attached schedule] schedule] Note: dditional page(s) must be identified by the Electical Installation Cetificate seial numbe and page numbe(s) N/ + ll boxes must be completed to Indicate an Inspection has been caied out and the esult is satisfactoy N/ to Indicate the Inspection is not applicable to a paticula item x to Indicate an Inspection has been caied out and the esultis not satisfactoy (applicable fo a peiodic spection only) Page 3 of 5

SCHEDULE OF CIRCUIT DETILS FOR THE INSTLLTION Boad Details TO BE COMPLETED IN EERY CSE Location of distibution boad Supply to distibution boad is fom ONLY TO BE COMPLETED IF THE DISTRIBUTION BORD IS NOT CONNECTED DIRECTLY TO THE ORIGIN OF THE INSTLLTION ssociated (if any) No of phases Nomal oltage No of poles Distibution boad designation Ovecuent potective device fo the distibution cicuit Ratg atg, m Cicuit Details Cicuit numbe and phase Cicuit designation of wig Refeence method No of pots seved Cicuit conductos csa Live cpc mm mm Max. pemitted disconnection time s Ovecuent potective device Ratg No Shot cicuit capacity k Op. cuent Max. pemitted Zs Wig Code B C D E F G H O PC/PC metallic conduit non-metallic conduit metallic tunkg non-metallic tunkg PC/SW XLPE/SW Meal sulated Page 4 of 5

SCHEDULE OF CIRCUIT TESTS FOR THE INSTLLTION Boad Tests ONLY TO BE COMPLETED IF THE DISTRIBUTION BORD IS NOT CONNECTED DIRECTLY TO THE ORIGIN OF THE INSTLLTION TEST INSTRUMENTS (SERIL NUMBERS) USED Zs Ipf Confimation of Supply polaity k Opeatg times of associated (if any) t t 5I n (if applicable) Eath fault loop impedance Insulation esistance Contuity Cicuit Tests Cicuit numbe and phase Rg fal cicuits only (measued end to end) Cicuit impedances 1 n (Le) (Neutal) (cpc) ll cicuits (t least one column to be completed) R + R 1 R Le/ Le Insulation esistance Le/ Neutal Le/ Eath Eath/ Neutal M M M M P o l a i t y Maximum measued eath fault loop impedance opeatg times t t 5 Tested By Signatue Position Date of testg Page 5 of 5