Gas Safe Bristol Boiler Only Survey 2024

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Property Type

undefined

• Detached House

• Semi detached house

• End of terrace

• Terraced House

• Ground floor flat

• 1st floor Flat

• 2nd floor flat

• 3rd floor flat

• Bungalow

• Mobile home

• Other type of building

• Picture of property

  Media

Existing Boiler type

• Combi / Sealed

• System boiler / Sealed

• Heat Only Boiler / Open Vented

• Heat Only Boiler / Sealed

• Other - SPECIFY BELOW

Existing Hot Water System Type

• Mains pressure / Combi

• Mains pressure / unvented cylinder

• Gravity / cylinder

• Is the existing hot water system fully pumped?

  Yes

  No

  N/A

• Are there any power showers which may be effected by the pressurisation of the hot water?<br>If YES specify below

  Yes

  No

• Notes

Existing Boiler Details

• MAKE / MODEL / OUPUT information required below

• Notes

• Picture of existing Boiler required

  Media

Existing Flue Details

• Balanced / Fan flue / Horizontal

• Balanced / Fan flue / Vertical

• Balanced / Natural Draught / Horizontal

• Balanced / Natural Draught / Vertical

• Open Flue / Vertical

• Open Flue / Horizontal

• Other - SPECIFY BELOW

• undefined

• Picture of Flue terminal

  Media

Existing Boiler Electrical Connections

• Permanent live supply ?

  Yes

  No

  N/A

• Switch live supply?

  Yes

  No

  N/A

• Pump over run supply?

  Yes

  No

  N/A

Existing Gas Supply To Boiler

• 15mm

• 22mm

• 28mm

• Photo of Gas Meter

  Media

Mains water Stopcock

• Where is the stopcock located

• Photo of stopcock location

  Media

Existing Controls

• Integral programmer and room stat

• External programmer and room stat

• Programmer only

• Programmable room stat

• Are the existing controls in a good and usable condition?

  Yes

  No

  N/A

• Picture of heating controls

  Media

• Does the system have TRV's

  Yes

  No

  N/A

• Do the existing controls platform comply with Part L building regulations?

  Yes

  No

  N/A

New Boiler Details

• Specify proposed new Boiler Details below E.G TYPE / OUPUT

• undefined

New Boiler Location

• Specify the new Boiler location taking into account minimum clearance and cupboards or other site restrictions in close proximity

  Select Existing location Kitchen (proposed new location) Airing cupboard (proposed new location) Roof space (proposed new location) Garage (proposed new location) Bedroom (proposed new location) Bathroom (proposed new location) Utility (proposed new location) Lounge (proposed new location) Dining room (proposed new location)

  • Existing location
  • Kitchen (proposed new location)
  • Airing cupboard (proposed new location)
  • Roof space (proposed new location)
  • Garage (proposed new location)
  • Bedroom (proposed new location)
  • Bathroom (proposed new location)
  • Utility (proposed new location)
  • Lounge (proposed new location)
  • Dining room (proposed new location)

• Will the Boiler be located in a cupboard?

  Yes

  No

• If YES Specify cupboard dimensions below (Height x Width x Depth)

• undefined

New Boiler Electrical Requirements

• Does the proposed new Boiler require a permanent live supply?

  Yes

  No

• Does the proposed new Boiler require a permanent pump over run supply?

  Yes

  No

• Will a suitably qualified electrician required to carry out Electrical amendments to the system?<br>If YES give details on scope of work required below

  Yes

  No

• Notes on what work is required

• Picture of fuse box

  Media

New Boiler Flue Details

• Vertical termination

• Horizontal termination

• Number of extensions required?

  0

  1

  2

  3

  4

• Number of 90 degree elbows required?

  0

  1

  2

  3

  4

• Number of 45 degree bends required?

  0

  1

  2

  3

  4

• Number of Flue support brackets required?

  0

  1

  2

  3

  4

• Is a lead slate required?

  Yes

  No

  N/A

• Are 300mm x 300mm access panels required

  0

  1

  2

  3

  4

Proposed New Controls Package

• What new controls are required?

  Select RF Programmable room stat RF Room stat only Mains room stat only Integral programmer (mechanical) and RF stat

  • RF Programmable room stat
  • RF Room stat only
  • Mains room stat only
  • Integral programmer (mechanical) and RF stat

• How many TRV's are required?

  Select 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15

• Size of new TRV’s

  8mm

  10mm

  15mm

New gas supply requirements

• Is the existing gas supply acceptable? <br>If NO give details of upgrade below

  Yes

  No

• Notes

• Is a new 28mm gas meter union required?

  Yes

  No

Condense pipe and termination point

• Is there an existing condense pipe?<br>If NO give details of proposed termination point

  Yes

  No

  N/A

• Air gap required, if so what type.

• Is a soak away required?

  Yes

  No

• Is a condense pump required?

  Yes

  No

• Condense insulation required?

Making Good

• Will there be any making good of the external wall?<br>If YES give details below

  Yes

  No

• Picture of external brick/wall face required

  Media

Core Material List

• How many metres of overflow pipe are required?

  3

  6

  9

  12

  15

• How many metres of 32mm plastic pipe are required?

  3

  6

  9

  12

  15

• How many metres of 40mm plastic pipe are required?

  3

  6

  9

  12

  15

• How many metres of 15mm tube are required?

  3

  6

  9

  12

  15

• How many metres of 22mm tube are required?

  Select 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 50 51 54 57 60

  • 3
  • 6
  • 9
  • 12
  • 15
  • 18
  • 21
  • 24
  • 27
  • 30
  • 33
  • 36
  • 39
  • 42
  • 45
  • 48
  • 50
  • 51
  • 54
  • 57
  • 60

• How many metres of 28mm tube are required?

  Select 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 50 51 54 57 60

  • 3
  • 6
  • 9
  • 12
  • 15
  • 18
  • 21
  • 24
  • 27
  • 30
  • 33
  • 36
  • 39
  • 42
  • 45
  • 48
  • 50
  • 51
  • 54
  • 57
  • 60

Access requirements

• Is scaffolding required

  Yes

  No

  N/A

• Type of Scaffold required

  Select

• Cherry Picker Access

  Yes

  No

  N/A

• Ladder Access only

  Yes

  No

  N/A

• External Access photographs

  Media

Job Notes

• Any additional notes