F192 Hot Cylinder Data Capture

• Location & Report Name

• Client

  Select Alliance Homes Cornwall Housing Dartford BC Exeter City Council Yarlington Housing Group Radian Other

  • Alliance Homes
  • Cornwall Housing
  • Dartford BC
  • Exeter City Council
  • Yarlington Housing Group
  • Radian
  • Other

General Details

• Risk Assesment Completed By

  Select Billy Wright Chris Balsom Jeremy Illy Sean Glossop Steve Britton Vinnie Stokes Jason Cole Lee Glenister Chris Lister

  • Billy Wright
  • Chris Balsom
  • Jeremy Illy
  • Sean Glossop
  • Steve Britton
  • Vinnie Stokes
  • Jason Cole
  • Lee Glenister
  • Chris Lister
• Location
  Address

• Date of Inspection

  Date

• Residents Name

• Residents contact details

Boiler Cylinder Photos

• Hot water cupboard photo and space infront of cupboard

  Media

• Hot water tank itself

  Media

• Insulation surrounding cylinder

  Media

• Pipework leading and entering cylinder

  Media

• Make and Cylinder capacity

  Media

Boiler Cylinder Information

• Measure Width and Height of Cylinder

• What age is the Cylinder?

• What is the make of the Cylinder?

• Is the Cylinder Insulated?

  Select No Insulation Present Lose Insulation Jacket Spray Foam Insulation Recently Replaced

  • No Insulation Present
  • Lose Insulation Jacket
  • Spray Foam Insulation
  • Recently Replaced

• What Capacity is the cylinder?

• Are there resident belongings that need to be moved?

• Are we in receipt of or have access to the asbestos survey or register for this property ?

  Yes

  No

• Has asbestos been identified ?

  No

  Yes

• Comments

• Photographic evidence

  Media

• Asbestos Survey Summary

  Media

Assessment Sign off

• Surveyors Name

  Sign