Title Page
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Client / Contract:
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Site Address:
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Conducted on:
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QC Inspector Name:
- Alan Lowe
- Alexandra McGregor
- Jamie Templeton
- Jim Payne
- Kevin Traynor
- Lee Milne
- Rhys Phillips
- Roddy Stanton
- Scott Clarke
- Stuart Laming
- James Malone
- Other
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QC Inspector Name:
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Operative Name(s):
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Location
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Work Scope
Electrical Safety Checks
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Appliance electrical circuit point of isolation correctly identified?
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Operative demonstrated safe electrical isolation, positive confirmation (correct method / equipment used)?
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All measuring testing instruments and equipment suitable and sufficient for task?
Phone / Tablet Device
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Phone / Tablet Device - Free from Damage?
Gas Safety Checks
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Operative working within gas competences as recorded on GasSafe Registration / ID Card
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Operative demonstrated competencies with regards to Regulation 26(9) checks
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Operative demonstrated ability to carry out tightness test
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Operative demonstrated ability to purge appliances
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Operative demonstrated ability to check meter and appliance working pressures
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Operative demonstrated ability to confirm heat input (gas rate appliance)
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Operative demonstrated ability to commission appliance, as per manufacturers instructions
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Operative demonstrated ability to visually inspect other appliances on site
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Operative demonstrated ability to carry out a combustion analysis
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Operative demonstrated ability to assess CO alarm location and operation
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All measuring, testing instruments and equipment suitable and sufficient for task
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Operative demonstrated ability to correctly record work report (electronic or paper)
Industry Unsafe Situations Procedure
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Confirm Operative is familiar with GIUSP
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Confirm Operative has a copy / access to GIUSP
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Confirm Operative has GIUSP associated labels and warning notices
Equipment Checks (including calibration where applicable)
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Manometer
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Flue Gas Analyser
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Hoover
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Fire Extinguisher
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Continuity Bonds
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PPE Kit Bag - with all required PPE Kit present
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First Aid Kit
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Uniform
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Van Stock
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Electrical Tester
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Adequate Toolkit
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Ladders
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Vehicle Condition
Vehicle - Condition and Use
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Is the Vehicle Parked in a Suitable Location / Area?
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Is the vehicle in good condition?
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Is the vehicle damage free?
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Vehicle Exterior - Clean and free from damage?
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Vehicle Interior (Drivers Cab) - Clean / Tidy and free from damage?
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Vehicle Interior (Rear / Storage) - Clean / Tidy and free from damage?
Consumables Check
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Regin Q160 brass pressure test nipples
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Regin zoom spout oiler
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Centre brand leak detector fluid
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3-Amp Fuses
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1-Amp Fuses (Fast Blow)
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Centre Brand Smoke Pellets
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Centre Brand Smoke Matches (Pk 75)
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Closure Plate Tape
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Gas Meter Washers 1"
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Gas Meter Washers 3/4"
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Meter Sealing Discs 1"
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Meter Sealing Discs 3/4" (Pk 5)
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Meter On / Off Tape
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15mm York Cap Ends
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22mm York Cap Ends
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1/4" MI Plugs
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3/8 Fl Cap
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Warning Label(s)
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Warning Notice(s)
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No Access Cards
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Dustsheets
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Carbon Monoxide / CO Alarm(s)
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If 'Yes' - please note how many CO Alarms are present:
Site Inspection Results / Conclusions
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Overall Score:
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Comments / Details of Failures:
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Further Action(s) / Training Required:
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Gas Operative Signature:
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Site QC / Inspector Signature:
