Emergency Lighting Certificate - Building Group Surveys

Property & Client Details

Property Address *

Client/Duty Holder Name *

Client Address

Property Type *

Test Date *

Next Test Due *

Maximum Occupancy

Facility Manager/Contact

Qualified Tester Details

Tester Name *

Qualifications *

Company Name

Company Address

Contact Phone

Contact Email

Emergency Lighting System Overview

System Type *

Total Number of Emergency Lights *

Number of Exit Signs

Number of Escape Routes

Test Duration (minutes) *

Previous Test Date

System Description

Emergency Lights Testing Results

BS 5266 Compliance Testing

Each emergency light must be tested for operation, duration, and illumination levels in accordance with BS 5266-1

Emergency Light 1

Location *

Light Type *

Lamp Type

Wattage

Rated Duration (minutes)

Battery Type

Function Test Result *

✅

PASS
Functions correctly

❌

FAIL
Does not function

➖

NOT TESTED
Unable to test

Duration Test Result *

✅

PASS
Full duration achieved

❌

FAIL
Insufficient duration

➖

NOT TESTED
Function test failed

Illumination Level (lux)

Actual Duration Achieved (minutes)

Defects Identified

Remedial Action Required

Overall System Performance

BS 5266-1 Compliance Requirements

Emergency lighting must provide adequate illumination for safe evacuation and comply with minimum performance standards

Test Type Performed *

Overall System Result *

Lights Tested - Pass

Lights Tested - Fail

Escape Route Coverage

Minimum Illumination Achieved

System-Wide Defects

Recommendations

Certificate Completion

Compliance Statement *

Limitations of Testing

Certificate Issue Date *

Certificate Valid Until *

Tester Digital Signature *

Copy Provided To

Recommended Retest Frequency