Information
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Project Reference
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Client / Site
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Conducted on
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Prepared by
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Location
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Telephone Number
1. Heat Pump
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Make
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Model
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Serial Number Outdoor (Please take Picture)
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Serial Number Indoor (Please take Picture)
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Picture of ID Plate
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Heat Pump Type
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Ground Loops Pressure tested?
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Ground Loops filled with Glycol and tested
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Manifold Checked for Leaks/Serviceability?
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Number of loops
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Length of loops (m)
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Freeze Protection of Glycol
2. Heating System
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Primary Heating System
4.2. Loads lifted over persons, close proximity to obstacles incl. overhead power lines?
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Number of Manifold ports
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Pipe Centres (mm)
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Heat Curve
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Secondary Heating System
4.10. SWL of plant or any lifting equipment exceeded?
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Heat Curve
3. Domestic Hot Water Storage
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Hot Water Storage
4.5. Lack of daily inspection protocol?
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Model
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Serial Number
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Benchmark
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Cylinder Type
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Capacity (Litres)
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Legionella Protected
4. Settings
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Outdoor Temperature
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Room Temperature
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Supply Temperature
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Return Temperature
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Hot Water Temperature
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Brine In Temperature
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Brine Out Temperature
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Heating Stop Temperature
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Hot Water Stop Temperature
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Operating Time Hot Water
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Operating Time Heating
5. Installation Details
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System installed to Building Regulations
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Correctly sized electrical supply and isolator fitted
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All sensors connected and functional
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Isolation Valves and Filter devices fitted
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Unvented DHW safety devices fitted/serviceable
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Flexible hoses fitted on Heating Flow and Return
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All UFH actuators/controls working
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Heat Pump connected to Internet
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Cooling Enabled
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Hot water checked at all outlets
Job Status
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Job Complete
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Parts required
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Quote required
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Return visit
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Commissioned
Corrective Actions
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Enter any corrective actions that will be undertaken
Sign Off
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Customer or On site representative
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Auditor's Signature