Gas Compliance Audit emh v1.5

Audit details

• Job Reference Number

Operatives Name

• Auditor

• Location
  Address

• Gas Safe Registration number

• Gas Safe Licence number

• Work Type

  Service

  Repair

  Install

  LGSR

• Contract

  IMS

  T&S

  PG

• Audit type

  Work In Progress

  Post complete

• Conducted on

  Date

• Date work carried out

  Date

Appliances

Appliance

Appliance Details

• Appliance Type

  CEN

  WAT

  HTR

  CKR

  OTHER

• Photo of appliance

  Media

• Flue type

  RS

  OF

  FL

• Horizontal

  Vertical

  Not Applicable

• Make

• Model

• Landlords Appliance

  Yes

  No

  N/A

• Location

  Select Kitchen Utility room Lounge Bedroom Bathroom Hall Loft

  • Kitchen
  • Utility room
  • Lounge
  • Bedroom
  • Bathroom
  • Hall
  • Loft

• Type of inspection

  Technical / Physical

  Visual

Appliance checks

• 1) Flue route / construction / support / termination

  Pass

  Fail

  N/A

• 2) Ventilation size / configuration

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 3) Appliance installed to manufacturers instructions

  Yes

  No

  N/A

• Pass

  Fail

  Not Applicable

• Add media

  Media

• 4) Appliance controls and operation

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 5) Fuse rating checked

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 6) Appliance cleaned / inspected

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 7) Flue operational and visual checks

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 8) Safety device operation

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 9) Burner pressure /Rated input

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• Inlet pressure Mbar =

• Operating pressure Mbar =

• NET INPUT kWh =

• 10) Flue integrity

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• FGA readings High CO2%/COppm/Ratio

• FGA readings Low CO2%/COppm/Ratio

• Add media

  Media

Pipework and meter installation

• 11) Meter installation / ECV / Labels

  Pass

  Fail

  N/A

• 12) Tightness test / LDF used in disturbed joints

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 13) Visual inspection of pipework

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 14) MEB (bonding)

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• Working pressure Mbar =

• Comments

Unsafe situations

• 15) Unsafe situations correctly identified

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 16) Warning label attached / notice issued

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• 17) Installation left safe to use

  Pass

  Fail

  N/A

• undefined

• Add media

  Media
Smoke detectors.

• Make

• Type

  Hard wired

  Battery

• Expiry date

  Date

• Tested

  Pass

  Fail

  N/A
Carbon Monoxide Dectector

• Make

• Type

  Hard wired

  Battery

• Expiry date

  Date

• Tested

  Pass

  Fail

  N/A

Documentation

• 18) Documentation

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

• Missing information

• 19) Work record / LGSR completed correctly

  Pass

  Fail

  N/A

• undefined

• Add media

  Media

WIP

• 20) Customer liaison / interaction

  Pass

  Fail

  N/A

• Comments

• Add media

  Media

• 21) Operative worked in a safe manner

  Pass

  Fail

  N/A

• Comments

• Add media

  Media

• 22) Protection of customers property (e.g. Dust sheets used)

  Yes

  No

  N/A

• Comments

• Add media

  Media

• 23) I.D. / Licence card shown

  Yes

  No

  N/A

• undefined

• Add media

  Media

• 24) Operative carries relevant reference material

  Yes

  No

  N/A

• undefined

• Add media

  Media

• 25) Safe isolation carried out

  Yes

  No

  N/A

• undefined

• Add media

  Media

• 26) Prelim electrical tests done

  Yes

  No

  N/A

• undefined

• Add media

  Media

• 27) Engineer has relevant tools and equipment

  Yes

  No

  N/A

• undefined

• Add media

  Media

Scores and outcome

• Confirm all questions answered.

• Overall outcome

  Select Above 90% = PASS Between 70 and 89% = Corrective action required Below 69% = unsatisfactory

  • Above 90% = PASS
  • Between 70 and 89% = Corrective action required
  • Below 69% = unsatisfactory

• OPERATIVE SIGNATURE (WIP only)

  Sign

• AUDITORS SIGNATURE

  Sign

• Corrective action information

Corrective action

• Who will be involved in closing the corrective action

  Select Operative Line Manager RGTA National Compliance Manager

  • Operative
  • Line Manager
  • RGTA
  • National Compliance Manager

• What are the recommendations

• What actions have been implemented

• What is the target date to close the corrective action

  Date

• Operative signature confirming action implemented is understood

  Sign

• Auditors Signature

  Sign

• 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.