Central London Failed On Day

• Engineer name

• H.S.A name

• Customers Address
  Address

• Job Number

• Conducted on

  Date

• Visit Completed By

Failed Process

• Did installer contact DHM before leaving site?

  Yes

  No

  N/A

• Has the H.S.A been contacted to discuss issues?

  Yes

  No

  N/A

• Has DHM contacted DSM?

  Yes

  No

  N/A

• Did a manager visit site?

  Yes

  No

  N/A

• Have all ASP's been raised to complete install?

  Yes

  No

  N/A

• Has new install date been planned?

  Yes

  No

  N/A

Failed Reason

• Cause and Reason for Fail?

• Boiler?

  Yes

  No

  N/A

• Asbestos?

  Yes

  No

  N/A

• Flue?

  Yes

  No

  N/A

• Condense?

  Yes

  No

  N/A

• Electrical?

  Yes

  No

  N/A

• System Design?

  Yes

  No

  N/A

• Near Miss Raised?

  Yes

  No

  N/A

Sales compliance

• Paperwork/Specification correct?

  Yes

  No

  N/A

Picture section

• Boiler

  Media

• Asbestos

  Media

• Flue

  Media

• Airing Cupboard

  Media

• Condense

  Media

• Electrical

  Media

• Notes

  Media

• Other

  Media

Customer Agreement

• Changes to specification

• Are changes chargeable?

  Yes

  No

  N/A

• Customer signature

  Sign