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Form 4 Form No: …………..

/4

GENERIC SCHEDULE OF TEST RESULTS


DB reference no ........................................................... Details of circuits and/or installed equipment vulnerable to damage when Details of test instruments used (state serial and/or asset numbers)
Location ........................................................................ testing ................................................................................................................. Continuity ............................................................................................
Zs at DB () ................................................................. .............................................................................................................................. Insulation resistance ...........................................................................
Ipf at DB (kA) ................................................................. .............................................................................................................................. Earth fault loop impedance .................................................................
Correct supply polarity confirmed  .............................................................................................................................. RCD ....................................................................................................
.............................................................................................................................. Earth electrode resistance ..................................................................
Phase sequence confirmed (where appropriate) 
Test results
Tested by:
Name (Capitals) ......................................................................................
Ring final Continuity RCD
Insulation

Polarity
Signature .............................................................. Date .................................. () Zs Remarks
circuit continuity (R1 + R2)
Resistance
(M) () (continue on a separate sheet if necessary)
() or R2
Circuit details
(ms)
Overcurrent device Conductor details
Circuit number

capacity (kA)

Test button /
functionality
Live (mm2)
Reference

cpc (mm2)

(R1 + R2) *
rn (neutral)
rating (A)

Circuit Description

Live-Live
breaking
BS (EN)

Method

r1 (line)

r2 (cpc)

@ 5In
Live-E

@ In
type

R2
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

* Where there are no spurs connected to a ring final circuit this value is also the (R1 + R2) of the circuit.

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