Title Page
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Site conducted
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Site no
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Conducted on
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Prepared by
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Location
Gas Appliance
- Appliance details
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Location of boiler
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Make of boiler
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Model of boiler
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Boiler data badge
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Photograph of appliance
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Approx age of boiler (yrs)
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Condition of boiler
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Do you recommend the boiler should be replaced
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Comments
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Are there any more boilers onsite