Certificate of Electrical Compliance of Public Building (Form 5)

Certificate of Electrical Compliance of Public Building (Form 5)
Health Act (Miscellaneous Provisions) 1911

Health (Public Buildings) Regulations 1992 (Reg.10)
Team Name
I certify that the electric light and/or power – installation, alteration, addition of the premises below has been carried out in accordance with Health (Public Buildings) Regulations 1992.
Name of Occupier*
Premises Details
Name of Public Building*
Address of Premises*
Particulars of Installation
Describe any electrical work for which you are not responsible in the premises
Signature of licensed electrical contractor or electrical worker authorised to sign on behalf of the electrical contractor/in-house electrical installer*

Clear
Contractor’s / in-house electrical installer’s details
Business Name*
Registration No.*
Address*
Telephone*
Email Address*
example@example.com
Should be Empty:

Contractor’s / in-house electrical installer’s details