17TH Edition

Domestic Electrical Installation

Periodic Inspection Report
Guidance for recipients
This Periodic Inspection Report form is intended for reporting on the condition of an existing electrical installation.
You should have received an original Report and the Contractor should have retained a duplicate. If you were the person ordering this Report, but not the owner of the installation, you should
pass this Report or a full copy of it including the schedules, immediately to the owner
The “original” Report should be retained in a safe place and be 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 owner with details of the condition of the electrical installation at the time this Report was issued.
The ‘Extent and Limitations’ box should fully identify the extent of the installation covered by this Report, and any limitations on the inspection and tests. The contractor should have agreed
these aspects with you and with any other interested parties (Licensing Authority, Building Society etc.) before the inspection was carried out.
The Report will usually contain a list of recommended actions necessary to bring the installation up to the current standard. For items classified as ‘Requires urgent attention’, the safety of
those using the installation may be at risk, and it is recommended that a competent person undertakes the necessary remedial work without delay.
For safety reasons, the electrical installation will need to be re-inspected at appropriate intervals by a competent person. The maximum time interval recommended before the next inspection
is stated in the Report under ‘Next Inspection’.
domestic electrical installation periodic
inspection report (for a single dwelling)
IMPORTANT HOUSEHOLDER INFORMATION
This Safety Certificate is an important and valuable document Elecsa
Certificate
which should be retained for future reference Registration
Number
Number

A. details of the client Client’s Name and Address B. particulars of the contractor

c. Address and details of the installation

Installation Address Estimated age of the electrical installation years

Evidence of alterations or additions Estimated age years

Electrical Installation
Date of previous inspection Certificate Number
if known or previous Periodic
Inspection Report number

Records of installation available Records held by

D. purpose of the report

e. EXTENT OF THE INSTALLATION AND LIMITATIONS OF THE INSPECTION AND TESTING

Extent of the electrical installation covered by this report

Agreed limitations, if any, of the inspection and testing

This inspection has been carried out in accordance with BS7671:2008 amended to (date ). Cables concealed within trunking and conduits, or cables and conduits concealed under floors,
in roof spaces and generally within the fabric of the building or underground have not been inspected.

F. summary of the inspection

General condition of the installation (continue with additional pages, which must be marked with Domestic Periodic Inspection Report serial number and page numbers)

g. Declaration
I, being the person responsible (as indicated by my signature below) for this report, particulars of which are set out 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, provides an accurate assessment of the condition of the electrical installation, taking into account the stated extent of
the installation and the limitation of the inspection and testing.

I further declare that the installation was in overall condition at the time of the inspection and that it should be further inspected as recommended

Satisfactory/Unsatisfactory

For the Inspection, Testing and Assessment

Date
Signature

Name Position
(capitals)

Distribution: top copy - For person ordering work; 2nd copy - Retained by Contractor Page 1 of 17th V1 - 06/08
domestic electrical installation periodic
inspection report (for a single dwelling)
IMPORTANT HOUSEHOLDER INFORMATION
This Safety Certificate is an important and valuable document Elecsa
Certificate
which should be retained for future reference Registration
Number
Number

h. observations and recommendations of action to be taken

Referring to the attached schedules of inspection and test results and subject to the limitation stated (see E) There are no items adversely The following observations and
affecting electrical safety recommendations are made

Item
Code
No.

If necessary continue with additional page(s) which must be marked with

Domestic Periodic Inspection Report serial number and page number Urgent remedial work recommended for items
Codes: 1. Requires urgent attention 2. Requires improvement
3. Requires further investigation 4. Does not comply with BS7671: This does
not imply that the electrical installation Corrective action(s) recommended for items
inspected is unsafe

I. next inspection
I recommend that this installation is further inspected and tested after an interval of not more than

provided that items in H which have been attributed a code 1 are remedied without delay. Items which have a code 2 or 3 should be actioned as soon as possible.

j. Supply characteristics, earthing and bonding

System Characteristics of primary supply
Supply characteristics Main switch or circuit breaker
Type(s) overcurrent protective device(s)
(1) By enquiry (2) By enquiry or measurement Type Current
BS EN Rating, In A BS EN
Nominal
TN-S V Voltage RCD Operating
Voltage(s) U(1) V mA
Rating current, IΔn Type
External earth
TN-C-S Nominal fault loop RCD Operating
Hz No. of Poles ms Nominal current A
Frequency,  f(1) impedance,  Ze(2) Time at IΔn
rating
Prospective Fault Supply Supply
TT kA Ω mm2 conductors Short circuit kA
current,  Ipf(2) Conductors
csa material capacity

Means of earthing
Method of
Distributor’s Installation Type e.g. rod(s), Electrode Location
Ω Measurement
facility earth electrode tape, etc. resistance, RA

Earthing conductor Main equipotential bonding conductors Bonding conductors of extraneous conductive parts
Conductor material Conductor material Water service Structural Steel

Conductor csa mm2 Conductor csa mm2 Oil service Lightning Protection

Continuity check Continuity check Gas Service Other incoming service

Distribution: top copy - For person ordering work; 2nd copy - Retained by Contractor Page 2 of 17th V1 - 06/08
domestic electrical installation periodic inspection report (for a single dwelling)
IMPORTANT HOUSEHOLDER INFORMATION
This Safety Certificate is an important and valuable document Elecsa
Registration Certificate
which should be retained for future reference
Number Number

K. Schedule of items inspected Prevention of mutual detrimental influences Cables and conductors continued L. additional Schedule of items
Methods of protection against electric shock o Proximity of non-electrical services and other influences o Additional protection provided by 30mA RCD for cables in concealed walls (where Inspected (where applicable)
o SELV o Segregation of band I and band II circuits or band II insulation used required in premises not under the supervision of a skilled or instructed person) o Limitation of discharge of energy
o Insulation of live parts and Barriers or Enclosures Identification o Cables incorporating earthed armour or sheath, or run with an earthed wiring o Obstacles
o system, or otherwise adequately protected against nails, screws and the like o
Presence of RCD for additional protection o Presence of Diagrams, instructions, circuit charts and similar information Placing out of reach
General
o Presence of earthing conductor and circuit protective conductors o Presence of danger notices and other warning notices o PELV
o o Presence and correct location of appropriate devices for isolation and switching
o
Presence of protective bonding conductors o Labelling of protective devices switches and terminals Presence of earthing arrangements for combined protective and functional
o o Adequacy of access to switchgear and other equipment purposes
Use of Class II equipment or equivalent insulation o Identification of conductors
o Presence of supplementary bonding conductors if required Cables and conductors
o Particular protective measures for special installations and locations o Presence of adequate arrangements for alternative source(s), where
o Routing of cables in prescribed zones or with mechanical protection
o Connection of single-pole devices for protection or switching in line applicable
conductors only o Non conducting location: absence of protective conductors
Notes o Connection of conductors
o Correct connection of accessories and equipment
3 to indicate that an inspection has been carried out and the result is
o Erection methods
o Earth-free equipotential bonding: presence of earth-free equipotential
satisfactory o Choice and setting of protective and monitoring devices for protection against bonding conductors
5 to indicate that an inspection has been carried out and the result was o Selection of conductors for current-carrying capacity and voltage drop fault and/or overcurrent o Electrical separation
unsatisfactory
N/A to that the inspection is not applicable o Presence of fire barriers, suitable seals and protection against thermal effects o Selection of equipment and protective measures appropriate to external influences o Segregation of safety circuits
LIM to indicate that, exceptionally, a limitation agreed with the person
ordering the work prevented the inspection or test being carried out o Selection of appropriate functional switching devices o Presence of undervoltage protective devices

Location of consumer unit(s).......................................................................................................................... Designation of consumer unit(s).......................................................................................... Prospective fault current at consumer unit(s)...............................................kA
Installed circuit details Circuit conductors: Test results Maximum

BS 7671(optional)
Overcurrent protective devices RCD Insulation resistance RCD operating times

Polarity
measured

permitted by
csa

Maximum Zs
Circuit impedances (Ω)
Points Served

current IΔn
Number of

BS EN All circuits (at least one column earth fault loop

Short Circuit

Operating
Live cpc Ring final circuits only Live/Live Live/Earth at IΔn at 5 x IΔn
Rating.

Capacity.
Type
Circuit No.

(measured end to end) to be completed) impedance if applicable

Circuit designation (for Distribution Circuits, insert “D”) No. Zs
mm2 mm2 A kA mA Ω R1 Phase Rn Neutral R2 CPC R1 + R2 R2 MΩ MΩ 3 Ω ms ms

Test instruments used

Serial or Other Reference Number - Insulation Resistance Continuity RCD Loop Impedence Earth Electrode Resistance
Distribution: top copy - For person ordering work; 2nd copy - Retained by Contractor Page 3 of 17th V1 -06/08