[भा III— ण्ड 4] भार ाराजपत्र:असाधार 153
FORM II
[See Regulation (32) and (45)]
(Installations of voltage level more than 250 V up to and including 650 V)
Report / Application No. __________
Date of inspection by Electrical Inspector or self-certification by supplier/owner/consumer
______________________________
Date of last inspection or self-certification ___________________
1. Consumer No. ______________________
2. Voltage and system of supply:
(ii) Volts _____________(ii) No. of Phases _____________ (iii) AC/DC _______________
3. Name of the consumer or owner _____________________________
4. Address of the consumer or owner _____________________________
5. Location of the premises _____________________________
6. Particulars of the installations:
(a) Motors:
Make S. No. kW/MW rating Voltage rating Type
(i) ________________________________________________________________
(ii) ________________________________________________________________
(b) Other equipment (complete details to be furnished):
(i) ________________________________________________________________
(ii) ________________________________________________________________
(c) Total connected load kW / kVA _________________________________________
(d) Generators: (complete detail to be enclosed)
Make S. No. kVA rating Voltage rating Type
(iii) ________________________________________________________________
(iv) ________________________________________________________________
7. General condition of the installation:
Sl.No. Regulation No. Requirements Report
1. Regulation 3 Is the record of the designated persons properly made and kept Yes/No
up to date and duly attested?
2. Regulation 14 (i) Is/Are there any visible sign(s) of overloading in respect Yes/No
of any apparatus wiring?
(ii) Whether any unauthorised temporary installation exist? Yes/No
(iii) Are the electric supply lines and apparatus so installed, Yes/No
protected, worked and maintained as to prevent danger?
(iv) Any other general remarks.
3. Regulation 15 Give report on condition of service lines, cables, wires, Satisfactory/
apparatus and such other fittings placed by the supplier or
Not Satisfactory
owner of the premises. If not satisfactory, give details.
4. Regulation 16 Whether suitable cut-outs/CBs provided by the supplier at the Yes/No
consumer‟s premises are within enclosed fire proof
receptacle?
5. Regulation 17 (i) Whether switches are provided on live conductors? Yes/No
(ii) Whether indication of a permanent nature is provided as Yes/No
per regulation so as to distinguish earthed or earthed
neutral conductor from the live conductor as per IS color
154 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4]
code?
(iii) Whether a direct line is provided on the neutral in the case Yes/No
of single-phase double pole iron clad
switches/Isolators/CBs instead of fuse?
6. Regulation 18 (i) Whether earthed terminal is provided by the supplier? Yes/No
(ii) General visible condition of the earthing arrangement. Satisfactory/
Not Satisfactory
7. Regulation 19 (i) Are bare conductors in building inaccessible? Yes/No
(ii) Whether readily accessible switches have been provided Yes/No
for rendering them dead?
8. Regulation 20 12. Whether “Danger Notice” in Hindi and the local language of Yes/No
the district and of a design as per the relevant standards is
affixed permanently in conspicuous position?
9. Regulation 21 (i) Whether insulating floor or mats have been provided? Yes/No
(ii) Whether identification of panel has been provided on the Yes/No
front and the rear of the panel?
10. Regulation 23 Whether flexible cables used for portable or transportable Yes/No
equipment covered under the regulation, are heavily insulated
and adequately protected from mechanical injury?
11. Regulation 24 State the condition of metallic coverings provided for various Satisfactory/
conductors.
Not Satisfactory
12. Regulation 26 Whether the circuits or apparatus intended for operating at Yes/No
different voltage(s) are distinguishable by means of
indication(s) of permanent nature?
13. Regulation 28 Whether all circuits and apparatus are so arranged that there is Yes/No
no danger of any part(s) becoming accidentally charged to any
voltage beyond the limits of voltage for which it/they is/are
intended?
14. Regulation 29 (i) In the case of generating stations, whether fire-buckets Yes/No
filled with clean dry sand have been conspicuously
marked and kept in convenient location in addition to fire-
extinguishers suitable for dealing with fires ?
(ii) Whether First Aid Boxes or cupboards conspicuously Yes/No
marked and properly equipped are provided and
maintained?
(iii) Is adequate staff trained in First Aid Treatment and Yes/No
firefighting?
15. Regulation 30 (i) Whether instructions in English or Hindi and the local Yes/No
language of the district and where Hindi is the local
language, in English and Hindi, for the resuscitation of
persons suffering from electric shock have been affixed in
a “conspicuous place”?
(ii) Are the persons specified under this Regulation able to Yes/No
apply instructions for resuscitation of persons suffering
from electric shock?
16. Regulation 36 State insulation resistance between conductors and earth in ----- Mega Ohms
Mega Ohms.
17. Regulation 37 (i) Whether a suitable linked switch, or circuit breaker is Yes/No
placed near the point of commencement of supply so as to
be readily accessible and capable of being easily operated
[भा III— ण्ड 4] भार ाराजपत्र:असाधार 155
to completely isolate the supply?
(ii) Whether every distinct circuit is protected against excess Yes/No
electricity by means of a suitable circuit breaker or cut-out
?
(iii) Whether suitable linked switch or circuit breaker is Yes/No
provided near each motor or apparatus for controlling
supply to the motor or apparatus?
(iv) Whether adequate precautions are taken to ensure that no Yes/No
live parts are so exposed as to cause danger?
18. Regulation 39 (i) Whether clear space of 100 cm is provided in front of Yes/No
the main switchboard?
(ii) Whether the space behind the switchboard exceeds 75 Yes/No
cm in width or is less than 20 cm?
(iii) In case the clear space behind the switchboard exceeds Yes/No
75 cm, state whether a passage way from either end of the
switchboard to a height of 1.80 metre is provided.
19. Regulation 43 (i) Have the frame of every generator, stationary motor and Yes/No
so far as practicable, portable motor and the metallic
parts (not intended as conductors) of all transformers and
any other apparatus used for regulating or controlling
electricity and all apparatus consuming electricity at
voltage exceeding 250 V but not exceeding 650 V been
earthed by two separate and distinct connections with
earth?
(ii) Have the metal casings or metallic coverings containing Yes/No
or protecting any electric supply line or apparatus been
properly earthed and so joined and connected across all
junction boxes as to make good mechanical and
electrical connection?
(iii) Whether the consumer‟s earth-electrode is properly Yes/No
executed and has been tested. If yes, give value of earth
_____Ohm
resistance?
(iv) Is the earth wire free from any mechanical damage? Yes/No
(v) Whether record of earth resistance value maintained? Yes/No
(vi) Is the protective equipotential bonding tested? Yes/No
(vii) Is the fault loop impedance at origin of installation Yes/No
tested?
(viii) Is the fault loop impedance of each circuit tested? Yes/No
(ix) Is the fault loop impedance tested for all sources? Yes/No
20. Regulation 44 Whether Residual Current Device of Appropriate capacity as Yes/No
defined in Regulation have been provided?
21. Regulation 47 Have the protections and interlocks for the generating units Yes/No
been provided. Details of the protections shall be given.
22. Overhead Lines (i) State if the consumer has any overhead lines. Yes/No
(ii) Does the overhead line near the premises of consumer Yes/No
meets the requirement of regulations 60, 61 and 62? If
not, give details.
(iii) Is guarding provided for overhead lines as per regulation Yes/No
76?
(iv) Any other remarks. Yes/No
156 THE GAZETTE OF INDIA : EXTRAORDINARY [PART III—SEC.4]
Date:
Signature of the supplier/ Owner / Consumer
Name ______________________
Designation _________________
File No. ____________________
To: Office of Electrical Inspector for ………………...
FORM III
(See Regulation 32 and 45)
(Installations of voltage exceeding 650 V)
Report / Application No. __________
Date of inspection by Electrical Inspector or self-certification by supplier/owner/consumer
______________________________
Date of last inspection or self-certification ___________________
1. Consumer No. ______________________
2. Voltage and system of supply:
(iii) Volts _____________(ii) No. of Phases _____________ (iii) AC/DC _______________
3. Name of the consumer or owner _____________________________
4. Address of the consumer or owner _____________________________
5. Location of the premises _____________________________
6. Particulars of the installations:
(a) Transformers: (complete detail to be enclosed)
Make S. No. kVA/MVA rating Voltage rating Type
(i) ________________________________________________________________
(ii) ________________________________________________________________
(b) Generators: (complete detail to be enclosed)
Make S. No. kVA/MVA rating Voltage rating Type
(v) ________________________________________________________________
(vi) ________________________________________________________________
(c) List of Motors with rating, protection, overload setting, size of earth conductor used to be furnished
Make S. No. kW/MW rating Voltage rating Type
(iii) ________________________________________________________________
(iv) ________________________________________________________________
(d) List of equipment with complete details of HT /LT switchgears/ apparatus with their rating to be furnished):
(iii) ________________________________________________________________
(iv) ________________________________________________________________
(e) Total connected load kW / kVA _________________________________________
Complete list of connected loads to be furnished.
7. General condition of the installation:
Sl. Regulation No. Requirements Report
No.
