| Report No: .............................. | Date of Inspection by Electrical Inspector or self certification by owner: ................ |
| Date of Last Inspection or self certification: ...................................................................................................... | |
| 1. | Consumer Name: ...................................................................................................... | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2. |
Voltage and system of supply: (i) Volts......................................................................................... (ii) No. of Phases ...................................................................... (iii) AC/ DC ........................................................................ |
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| 3. | Type of writing ........................................................................ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 4. | Name of the consumer or owner ........................................................................ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 5. | Address of the consumer or owner ........................................................................ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 6. | Location of the premises ........................................................................ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 7. | Particulars of the installations: | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Sl No. | Regulations Nos | Requirements | Report |
| 8 | Regulation 12 | (i) Is/ Are there any visible sign(s) of overloading in respect of any apparatus wiring? | Yes/ No |
| (ii) Condition of flexible cords, sockets, switches, plug-pins, cut-outs and lamp holders and such other fittings. | Satisfactory/ Not Satisfactory | ||
| (iii) General conditions of Wiring. | Satisfactory/ Not Satisfactory | ||
| (iv) Whether any unauthorized installation exists? | Yes/ No | ||
| (V) State of sockets are controlled by the individual switches | Yes/ No | ||
| (vi) Any other defect or condition which may be a source of danger. If yes, give details | Yes/ No | ||
| 9 | Regulation 13 | Give report on the condition of the service lines, cables wires, apparatus and such other fittings placed by the supplier or owner of the premise. If not satisfactory, give details | Satisfactory/ Not satisfactory |
| 10 | Regulation 14 | Whether suitable cut-outs provided by the supplier at the consumer's premises are within enclosed fire proof receptacle? | Yes/ No |
| 11 | Regulation 15 | (i) State if switches are provided on live conductors | Yes/ No |
| (ii) State if indication of a permanent nature is provided as per Regulation so as to distinguish neutral conductor from the live conductor | Yes/ No | ||
| (iii) Whether a direct line is provided on the neutral in the case of single phase double pole iron clad switches instead of fuse? | Yes/ No | ||
| 12 | Regulation 16 | (i) State if earthed terminal is provided by the supplier | Yes/ No |
| (ii) Have three pin plugs been provided for the plug points? | Yes/ No | ||
| (iii) General visible conditions of the earthing arrangement. | Satisfactory/ Not satisfactory | ||
| 13 | Regulation 17 | Are the live parts in accessible position? | Yes/ No |
| 14 | Regulation 34 | Leakage on Premises: State insulation resistance between conductors and earth in Mega ohms |
.... .M Ohms |
| 15 | Regulation 35 | (i) State if linked switches of requisite capacity are provided near the point of commencement of supply | Yes/ No |
| (ii) State if the wiring is divided in suitable number of circuits and each such circuit is protected by suitable cut-out. | Yes/ No | ||
| (iii) State if supply to each motor or apparatus is controlled by suitable linked switch | Yes/ No | ||
| 16 | Regulation 41 | (i) Have the frame of every generator, stationary motor and so far as practicable portable motor and the metallic parts (not intended as conductors) of all other apparatus used for regulating* or controlling electricity been earthed by two separate and distinct connections with earth? | Yes/ No |
| (ii) Is the earth wire free from mechanical damage? | Yes/ No | ||
| (iii) In the case of conduit, or lead covered wiring, has the conduit or lead cover been efficiently earthed? | Yes/ No | ||
| (iv) If the consumer has his own earth electrode, state if it is properly executed and has been tested. If yes, give value of earth resistance. ..... .M Ohms | |||
| 17 | Overhead lines | (i) State if the consumer has any overhead lines. | Yes/ No |
| (ii) Does the overhead line near the premises of consumer meets the requirement of regulations 58, 60 and 61? If not, give details. | Yes/ No | ||
| (iii) Is guarding provided for the overhead lines at road crossings? | Yes/ No | ||
| (iv) Any other remarks |
| Date: .............................. | Signature of the Inspection officer/ Self Certifying supplier or owner |
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Name: ..................... Designation: .............. File No: ..................... |
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| Copy forwarded to the Deputy Chief Electrical Inspector, Hyderabad/ Hyderabad(Rural)/ Electrical Inspector, Hyderabad/ Nizamabad for ......................................... | |
| * Note applicable to isolated wall tubes or to brackets, electroliers, switches, ceiling fans and such other fittings (other than portable head lamps and transportable apparatus) unless provided with earth terminal. | |
