Information
Audit details
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Audit Reference
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Company / Client / Contract
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RGTA
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Location
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Operatives Name
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Gas Safe Registration number
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Gas Safe Licence number
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Work Type
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Labour type
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Audit type
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Conducted on
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Date work carried out
Appliances
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Appliance
Appliance Details
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Photo of appliance
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Appliance Type
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Flue type
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Make
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Model
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Location
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Type of inspection
Appliance checks
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1) Flue route / construction / support / termination
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Add media
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2) Ventilation size / configuration
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Add media
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3) Appliance installed to manufacturers instructions
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Add media
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4) Appliance controls and operation
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Add media
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5) Fuse rating checked
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Add media
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6) Appliance cleaned / inspected
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Add media
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7) Flue operational and visual checks
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Add media
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8) Safety device operation
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Add media
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9) Burner pressure /Rated input
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Add media
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Inlet pressure Mbar =
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Operating pressure Mbar =
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NET INPUT kWh =
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10) ECGA TESTS
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Add media
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ECGA readings Ratio/CO2%/O2%/COppm
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Comments
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Add media
Pipework and meter installation
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11) Meter installation / ECV / Labels
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Add media
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12) Tightness test / LDF used in disturbed joints
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Add media
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13) Visual inspection of pipework
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Add media
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14) MEB (bonding)
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Add media
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MOP Mbar =
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Comments
Unsafe situations
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15) Unsafe situations correctly identified
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Add media
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16) Warning label attached / notice issued
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Add media
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17) Installation left safe to use
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Add media
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Add media
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Comments
Documentation
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18) Correct documentation available
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Add media
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19) Work record / LGSR completed correctly
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Add media
WIP
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WIP
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20) Customer liaison / interaction
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Add media
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21) Operative worked in a safe manner
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Add media
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22) Protection of customers property (e.g. Dust sheets used)
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Add media
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23) I.D. / Licence card shown
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Add media
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24) Operative carries relevant reference material
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Add media
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25) Safe isolation carried out
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Add media
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26) Prelim electrical tests done
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Add media
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27) Engineer has relevant tools and equipment
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Add media
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28) Under pinning knowledge
Question
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Question:
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Answer:
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Result:
Scores and outcome
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Overall outcome
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OPERATIVE SIGNATURE (WIP only)
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RGTA SIGNATURE
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Confirm all questions answered.
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Corrective action information
Corrective action
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Who will be involved in closing the corrective action
- Operative
- Line Manager
- RGTA
- National Compliance Manager
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What are the recommendations
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What actions have been implemented
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What is the target date to close the corrective action
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Operative signature confirming action implemented is understood
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Manager / RGTA signature confirming action implemented
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Corrective actions to be completed within the time specified or reason for non completion before specified time to be reported to RGTA. Completed corrective action to be sent back to issuing RGTA with supporting evidence where required, RGTA to close corrective action on monitoring system when satisfied appropriate action has been carried out.
