Gas safe

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Preliminary checks

• Previous inspection

  Yes

  No

  N/A

• Select date

  Date
• Add location
  Address

• Previous defects

  Yes

  No

  N/A

• Type of boiler

  Yes

  No

  N/A

• Make and data tag details

  Yes

  No

  N/A

• Location of boiler

  Safe

  At Risk

  N/A

• Gas family

  Yes

  No

  N/A

• Flue category a1,B11,C12etc

  Yes

  No

  N/A