Gas Heater Service V1.01

• Document No.

• Audit Title

• Conducted on

  Date

• Prepared by

Technician

• Tick Box

  Ian Field - GF016605

  Kya Ya - GF018606

  Russell Hill - GF010295

Location

• Add location
  Address

Clean And Adjust Room Heater

• Completed

• Clean Out Filter

  Yes

  No

  N/A

Test Gas Pressure

• Completed

• Result - KPA

• Images

  Media

Clean Pilot Light

• Pilot light cleaned

  Yes

  No

  N/A

Check Ventilation

• Tick Box

  Select Complies with Gas Standards AS/NZ 5601 Non Compliant Requires variation

  • Complies with Gas Standards AS/NZ 5601
  • Non Compliant
  • Requires variation

Manufacturer

• Manufacturer

  Rinnai

  Everdure

  Banksia

• Model

• Year of Manufacture

• Photo of Model No.

  Media

• Flued

• Unflued

Report Any Damage

• Damage

• Photos

  Media

• Current Condition

  Good

  Fair

  Poor

Carbon Monoxide Testing

• Carbon Monoxide Reading - CO

• Photo of reading

  Media