Forms

 

FormDescription
Application and Registration
Application FormDownload, complete and submit the Application for Registration form to Safe Electric if applying for Safe Electric membership.
The form can be also sent as a hardcopy to you, please contact Safe Electric office if you need a copy of the Application for Registration Form.
R44-Insurance Form V8The Certificate of Insurance should be filled, stamped and signed by the insurance company insurance broker if a contractor newly applies for Safe Electric membership, if the Registered Electrical Contractor (REC) changes insurance company (or broker) or to update the RECs insurance record with Safe Electric.
R47-Application Inspection Request-V2This form must be completed and signed by the applicant to inform the Safe Electric Inspector that an electrical work is ready for inspection. The applicant must be in attendance at time of the inspection. This inspection request form should be forwarded to the Safe Electric office at least 10 days before the inspection is required.
Completion Certificates – Samples
Certificate No. 1 (<50 kVA) – SampleCompletion Certificate for the connection of new electrical installations (less than 50kVA) to the Distribution System Operator (DSO) Network.
Certificate No. 2 (≥50 kVA) – SampleCompletion Certificate for the connection of new electrical installations (greater than or equal to 50kVA) to the DSO Network.
Certificate No. 3 – SampleThe non-DSO certificate covers alterations (including additions and extensions) to existing installations.
Agricultural Certificate – SampleAll electrical works in agricultural locations must comply with the National Rules for Electrical Installations, specifically Section 705 – Electrical Installations for Agricultural and Horticultural premises. A copy of the Agricultural Completion Certificate may be required by the Department of Agriculture for agricultural buildings grant-aid.
Interim electrical installations (≥50kVA) – SampleInterim Certificates are validated by Safe Electric to enable the main distribution board in an industrial or commercial installation to be energised so that a completed subsystem e.g. a lift system, or a standalone module, can be tested or commissioned. In this example the REC would place locks on the distribution board for all other circuits not completed and tested. Please refer to clause 63.3.1 in the Technical Rules for Electrical Installations – Fourth Edition ET 101: 2008.
Periodic Inspection Report - Sample
Periodic Inspection Report - SamplePeriod Inspection Report is used to record results of periodic inspection and testing of electronic installations. A PIR is intended to identify the condition of an electrical installation, be it good or bad. Testing with the appropriate electrical instruments shall be carried out in line with Chapter 61 and 62 of the National Rules for Electrical Installations. The REC must provide a copy of their PIR to their customer and explain the next steps required of the customer to bring the installation in line with the relevant standards.
Please note Periodic Inspection Report is a Report and not a Completion Certificate.
The presented PIR is a sample, blank forms can be purchased at the Safe Electric office.
Test Record Sheet - Sample
Test Record Sheet - SampleTests defined in the Technical Rules for Electrical Installations – Fourth Edition ET 101: 2008 shall be carried out on the electrical installation, both, before and after the installation is energised. The Test Record Sheet is to be used to record the test results and should be linked to the Completion Certificate. Testing is also part of the Periodic Inspections.
The presented Test Record Sheet is a sample, blank forms can be purchased at the Safe Electric office.
Inspection and Audit
R41 - Inspection Request Form – V4This form must be completed and signed by the electrical contractor / electrician to inform the Safe Electric Inspector that an electrical work is ready for inspection, e.g. in the change of contractor procedure. The electrical contractor / electrician must be in attendance at time of the inspection. This inspection request form should be forwarded to the Safe Electric office at least 10 days before the inspection is required.
Audit Report – SampleThis is a sample of the Audit Report form that the Safe Electric Inspector completes when he/she conducts an Audit. The form shows the requirements that the REC shall comply with in an Audit.
Audit Non-Conformance Notice – SampleThis is a sample of the Audit Non-Conformance Notice form. Any non-conformance found during an Audit it is automatically recorded on page 4 of the Audit Report i.e. the Audit Notice of Non-Conformance. The REC is required to confirm the rectification of the non-conformance(s) within 30 working days.
Inspection Report – SampleThis is a sample of the Inspection Report form that the Safe Electric Inspector completes when he/she conducts an Inspection. The form shows the requirements of the national Wiring Rules that the electrical work shall comply with.
Inspection Non-Conformance Notice – SampleThis is a sample of the Inspection Non-Conformance Notice form. Any breach found is automatically recorded on page 4 of the Inspection Report i.e. the Inspection Notice of Non-Conformance. The inspector records the date by which the breaches have to be rectified on the NC Notice and ticks the box “Non-Conformance notice issued”.
Complaints
R50 - Electrical Installation Complaint Form – V2You can make a complaint about the standard of workmanship of a Registered Electrical Contractor (REC) by filling the online form on the Safe Electric website or you can download this form and send to Safe Electric via post.
Notification of Potential Hazard and Emergency Works
R35 – Notice of Potential Hazard (NoHz) Form – V2 – SampleIn case the Registered Electrical Contractor (REC) carrying out installation works observes a potential hazard and is not in a position to rectify it, the REC should issue a Notice of Potential Hazard (NoHz). The presented form is a sample, blank NoHz forms can be purchased at the Safe Electric office.
R36 – Notice for Emergency Work – V3 – SampleThe Notice for Emergency Work form is completed by the Safe Electric inspector where the Safe Electric Inspector encounters a serious hazard on the electrical installation that can be a threat to health and safety and thus the installation shall be or remain to be energised. Please note, the presented form is a sample.