Application for Statutory Inspection of Electrical Installations under Regulation 43/36/32 of Central

Electricity Authority (Measures relating to Safety and Electric Supply) Regulations, 2010 for Approval
of the Electrical Inspector for Energization.
Application format for Electrical Installations (Other than overhead transmission lines).

(Form- A)
Note: Please note the instructions prior to filling the form as notified from time to time.
1. Name of the installation(s)(type and brief details):
2. Applicant:
a. Name of Owner of Organization and address:
b. Name and Address of Concerned officer :
(Including Phone/Mobile/ E-mail/Fax)
3. Interrupting capacity of Circuit breaker(S) :
4. Minimum ground clearance of the bare conductor:
5. Whether all the relevant provisions of the Central
Electricity (Measures relating to safety and
electric supply) Regulations,2010 have been
duly complied with? :
6. Whether the installations are placed in position,
properly joined, duly completed and is (are)
ready for energization. :
i. If, Yes-attach completion certificate and
Indicate the date(S) of installation
to be inspected :
ii. If, No-indicate targeted date of completion
and Probable’s date of dates of installation
to be inspected :
7. Enclosures:
a) List of Equipment offered for inspection. :
b) Site Test Results(Equipment wise)
i. Insulation Resistance test. :
ii. Earth Resistance
of Individual Electrodes. :
iii. Di Electric test (BDV) of Oil. :
c) Manufacturers Routine Test Certificate for
each equipment and cables. :
8. Copy of:
i. Contractor’s License. :
ii. Certificate of competency
of Electrical Supervisor. :

Signature of Owner/In-charge
Signature of Contractor with Seal of Installation
Date: _______________ Designation &Seal_____________
Date: ____________