Department of Communities/Housing Authority - Gas Audit - Maintenance Works and Service Contract.

• DoC Works Order Number:

• Property ID

• Property Address:
  Address

• Conducted on:

  Date

• Conducted by:

• Gas Type

  Reticulated

  Bottled

• Does the property have a Gas Meter?

  Yes

  No

• Is gas available?

  Yes

  No

• Has the supply been capped off?

  Yes

  No

• Comments

• Provide photograph of the Meter assembly

  Media

• Has the supply been capped off?

  Yes

  No

• What is required to reinstate the supply?

• Are the cylinders restrained and installed on a firm, level, non-combustible base, and not resting on soil.

  Yes

  No

• Are the cylinders positioned to comply with clearances to ignition sources, drains or openings into a building?

  Yes

  No

• Are the cylinder regulator and pigtails functional?

  Yes

  No

Piping

• Does the installation comply with AS/NZS 5601 Gas installations<br>Part 1: General installations.

  Yes

  No

Schedule of Rates required:

• SoR required

• Description

• Location

• Quantity

Non SoR labour:

• Tick the box if non scheduled labour is required

• Labour description

• Units of labour (per 1/4 HR increments)

Non SoR material:

• Tick the box if non scheduled material is required

• Material description

• Quantity

• Costings

• Photograph

  Media

Hot Water Unit

• Tick the box if a HWU is being inspected

• Type

• Photograph

  Media

• Does the installation comply with AS/NZS 5601 Gas installations

  Yes

  No

Schedule of Rates:

• SoR required

• Description

• Location

• Quantity

Non SoR material:

• Tick the box if non scheduled material is required

• Material description

• Quantity

• Costings

Non SoR labour:

• Tick the box if non scheduled labour is required

• Labour description

• Units of labour (per 1/4 HR increments)

Stove/Cooktop/Oven

• Tick the box if a Cooking appliance is being inspected

• Type

• Photograph

  Media

• Does the installation comply with AS/NZS 5601 Gas Installations

  Yes

  No

Schedule of Rates:

• SoR required

• Description

• Location

• Quantity

Non SoR labour:

• Tick the box if non scheduled labour is required

• Labour description

• Units of labour (per 1/4 HR increments)

Non SoR material:

• Tick the box if non scheduled material is required

• Material description

• Quantity

• Costings

Room Heater:

• Tick the box if a Room Heating appliance is being inspected

• Type

• Photograph

  Media

• Does the Installation comply with AS/NZS 5601 Gas Installations (including fluing and ventilation)

  Yes

  No

Schedule of Rates:

• SoR required

• Description

• Location

• Quantity

Non SoR labour:

• Tick the box if non scheduled labour is required

• Labour description

• Units of labour (per 1/4 HR increments)

Non SoR material:

• Tick the box if non scheduled material is required

• Material description

• Quantity

• Costings

• Has a Hazard been identified during the Audit? [A hazard is anything with the potential to cause injury or property damage].

  Yes

  No

• Recommended Actions

• Photograph

  Media

Additional Comments

• Is further Technical Information required

  Yes

  No

• Comments

License No

• Please provide Trade License details

Signature

• Please sign on completing the Audit

  Sign