Declaration of Test Results for LV New Cable Installations

Refer to Important Information over page before completing this form. General Details: Builder name and Site Address:

Power Systems o Ref. N :

Contractor Ref. N :

Site Agreement N :

Contractor Telephone Number:

Contractor Contact Name:

Work Details: Details of network Installed with associated drawings attached:

Mains Cable Pre-Energisation Commissioning Requirements:

Insulation Resistance

RN/E YN/E BN/E

(M )

RY RB YB

(M )

(M ) (M )

(M ) (M ) (Y, N, N/A)

Confirm LV Main Continuity Test Service Cable Commissioning Requirements: Pre-Energisation Commissioning
Plot Number LV Service Continuity Test (Y, N) Insulation Resistance (M )

Post Energisation Commissioning

Earth Loop Impedance ( ) Phase connected to (R, Y, B) Voltage Recorded Polarity confirmed correct (Y, N, N/A)

We hereby confirm this apparatus has been installed in accordance with PowerSystem requirements and the attached as-laid drawings. We confirm that individuals with appropriate training, knowledge and experience have tested the apparatus and that the results of those tests are accurately represented on this form. We hereby acknowledge that such apparatus must be regarded as live from the date shown below and that all relevant site personnel (including site agent) have been informed of this potential hazard. Signed (Print Name) Date .. For and on behalf of (name of Company) .. .. (Print Designation)

..

Continued over for additional services

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SP PowerSystems Limited

Page 1 of 2

9 October 2002

The following shall be observed:

Important Information

One form shall be submitted per section of mains cable tested / made live. Insulation resistance tests shall be carried out prior to connection to the system. The minimum acceptable insulation resistance value shall be 50 M for service cables and 50 M for mains cable although results should be comfortably above this. An earth loop impedance test shall be carried out at the service cut-out. The maximum acceptable earth loop impedance value shall be 0.35 for a PME earth or 0.80 for a non-PME earth. Should the earth loop impedance, insulation resistance or polarity check prove to be unsatisfactory, the supply shall be withheld from the customer until made good. The declaration over page MUST BE SIGNED. Service Cable Commissioning Requirements:

Pre-Energisation Commissioning
Plot Number LV Service Continuity Test (Y, N) Insulation Resistance (M )

Post Energisation Commissioning

Earth Loop Impedance ( ) Phase connected to (R, Y, B) Voltage Recorded Polarity confirmed correct (Y, N, N/A)

SP PowerSystems Limited

Page 2 of 2

9 October 2002

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