Emergency lighting completion record: free blank PDF
Download a printable emergency lighting completion record for England, Wales, Scotland, Northern Ireland. The PDF contains the record sections shown below and writing space for the actual findings.
Download the blank printable PDF for free.
Free blank Emergency lighting completion record form
Print the blank record and keep the completed copy with the job. The preview shows the actual blank download.
Blank Emergency Lighting Completion Certificate form
Record scope and contents
England, Wales, Scotland, Northern Ireland. The named persons responsible for the design, installation, verification or test within the recorded scope.
- Certificate Details: Certificate number, The installed work is, Date work completed
- Details of the Emergency Lighting Installation: Address, Postcode, Occupier, Extent covered, Exclusions
- Work location: Work jurisdiction
- Installed Emergency Lighting System: Purpose of emergency lighting, Arrangement of emergency lighting, Mode of operation, Rated emergency duration, Duration (minutes), Test facilities provided
- Photometric Design Basis: Photometric basis, Photometric data appended, Drawing no(s), EIC / MEIWC no.
- Emergency Luminaires
- Compliance Checklist
- Completion Test: Full-duration test date, Discharge duration, Normal supply restored, Recharge period
- Test Instruments Used: Light meter model, Light meter serial number, Last calibration date, Asset number, Calibration due date, Calibration certificate reference
- Deviations: Deviations identified, Deviation details
- Log Book and Next Inspection: Log book reference, Next inspection interval, Next inspection date
- Declaration of Conformity (Responsible Person): Installation conforms, Responsible Person, Organisation, Position, Signature, Date
Primary source for this record · checked 2 October 2026
What the Emergency lighting completion record covers
Record the system, extent of work, design and installation responsibility, inspection and test findings, deviations and sign-off. Completion and periodic-test purposes are selected in the record. The form does not provide the controlled design standard or certify the signer's competence.
Who needs one
- The named persons responsible for the design, installation, verification or test within the recorded scope.
- Record scope: England, Wales, Scotland, Northern Ireland.
- Keep the completed record with the source documents, findings and job reference.
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