Emergency Lighting Periodic Inspection & Test

1

CLIENT & SITE DETAILS

Client Name *

Client Contact / Tel

Client Email (optional — the certificate is emailed here)

Site Address *

Occupier

Date of Inspection *

Next Test Due *

No. of Luminaires Inspected

2

SYSTEM DESCRIPTION & CLASSIFICATION

Description & extent of the emergency lighting system covered *

Mode of Operation

Maintained

Non-maint.

Combined

System Type

Self-contained

Central battery

Declared Duration

1 hour

3 hours

Test(s) Performed *

Monthly function test

Annual full-duration test

As-built / record drawings on site?

Logbook present & checked?

3

BS 5266-1 INSPECTION & TEST CHECKLIST

Actual discharge duration

Retest date if failed

4

LUMINAIRE SCHEDULE

0 luminaires recorded

5

DEFECTS & REMEDIATION LOG

Defects / observations noted

6

OVERALL OUTCOME

The outcome is derived automatically from the recorded results: any checklist FAIL, any luminaire FAIL or charge-indicator defect, or any unresolved defect makes the system NOT fit for purpose. It cannot be set by hand.

7

DECLARATION

Name *

Position

Relevant qualification(s)

Basis of competency

Signature *

Date Certificate Issued

💡 Emergency Lighting — Select Job