Title Page
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
Property Type
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Detached House
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Semi-detached House
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Terraced House
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End of terrace
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Ground floor flat
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1st floor Flat
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2nd floor flat
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3rd floor flat
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Bungalow
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Mobile home
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Other - SPECIFY BELOW
Existing Heating System Type
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Combi / Sealed
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System boiler / Sealed
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Heat Only Boiler / Open Vented
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Heat Only Boiler / Sealed
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Other - SPECIFY BELOW
Existing Hot Water System Type
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Mains pressure / Combi
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Mains pressure / unvented cylinder
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Gravity / cylinder
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Is the existing hot water system fully pumped?
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Are there any power showers which may be effected by the pressurisation of the hot water?<br>If YES specify below
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Existing Boiler Details
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MAKE / MODEL / OUPUT information required below
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Picture of existing Boiler required
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Water flow rate if combination boiler
Existing Flue Details
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Balanced / Fan flue / Horizontal
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Balanced / Fan flue / Vertical
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Balanced / Natural Draught / Horizontal
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Balanced / Natural Draught / Vertical
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Open Flue / Vertical
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Open Flue / Horizontal
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Other - SPECIFY BELOW
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Picture of Flue terminal required
Existing Boiler Electrical Connections
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Permanent live supply ?
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Switch live supply?
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Pump over run supply?
Existing Gas Supply To Boiler
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15mm
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22mm
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28mm
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Photo of gas meter
Existing Mains Stopcock
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Where is the stopcock located
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Photo of location
Existing Controls
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Integral programmer and room stat
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External programmer and room stat
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Programmer only
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Programmable room stat
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Are the existing controls in a good and usable condition?
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Picture of heating controls
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Does the system have TRV's
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Do the existing controls platform comply with Part L building regulations?
New Boiler Details
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Specify proposed new Boiler Details below E.G TYPE / OUPUT
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New Boiler Location
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Specify the new Boiler location taking into account minimum clearance and cupboards or other site restrictions in close proximity
- 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)
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Is a standoff bracket required?
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Will the Boiler be located in a cupboard?
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If YES Specify cupboard dimensions below (Height x Width x Depth)
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New Boiler Electrical Requirements
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Does the proposed new Boiler require a permanent live supply?
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Does the proposed new Boiler require a permanent pump over run supply?
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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
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Notes on what work is required
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Picture of fuse box
New Boiler Flue Details
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Vertical termination
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Horizontal termination
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Number of extensions required?
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Number of 90 degree elbows required?
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Number of 45 degree bends required?
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Number of Flue support brackets required?
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Is a lead slate required?
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Are 300mm x 300mm access panels required
Proposed New Controls Package
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What new controls are required?
- RF Programmable room stat
- RF Room stat only
- Mains room stat only
- Integral programmer (mechanical) and RF stat
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How many TRV's are required?
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
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- 11
- 12
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- 15
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Size of required TRV
New gas supply requirements
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Is the existing gas supply acceptable? <br>If NO give details of upgrade below
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Is a new 28mm gas meter union required?
Condense pipe and termination point
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Is there an existing condense pipe?<br>If NO give details of proposed termination point
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Air gap required, if so what type
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Is a soak away required?
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Is a condense pump required?
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Condense insulation required
New Hot Water Cylinder
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Is a replacement hot water cylinder required?
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What type of hot water cylinder is required?
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Will the new hot water cylinder be installed to the existing location?<br>If NO give proposed location details below
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Picture of hot water cylinder being replaced
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New hot water cylinder size?
- 100L
- 120L
- 150L
- 170L
- 190L
- 200L
- 210L
- 250L
- 300L
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Is the cylinder direct or indirect?
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How many immersions does the new cylinder require?
Replacement Radiators
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How many radiators including towel rails are required?
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Details of all replacement radiators required below (SIZE / TYPE / ROOM / POSITION IN ROOM)
E.G 600 x 1000 K2 / Master Bed / Existing Location under window -
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How many new TRV's are required?
- 0
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
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- 15
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How many Lock-shields with drain off point are required?
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- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
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- 15
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How many standard lock-shields are required?
- 0
- 1
- 2
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- 4
- 5
- 6
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- 8
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- 12
- 13
- 14
- 15
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What size TRV's and lock shields are required?
Making Good
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Will there be any making good of the external wall?<br>If YES give details below
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Picture of external brick/wall face required
Core Material List
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How many metres of overflow pipe are required?
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How many metres of 32mm plastic pipe are required?
- 3
- 6
- 9
- 12
- 15
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How many metres of 40mm plastic pipe are required?
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In this section you are required to add a 'core material list' including quantity of tube, condense pipe, pumps and valves
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How many metres of 15mm tube are required?
- 3
- 6
- 9
- 12
- 15
- 18
- 21
- 24
- 27
- 30
- 33
- 36
- 39
- 42
- 45
- 48
- 50
- 51
- 54
- 57
- 60
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How many metres of 22mm tube are required?
- 3
- 6
- 9
- 12
- 15
- 18
- 21
- 24
- 27
- 30
- 33
- 36
- 39
- 42
- 45
- 48
- 50
- 51
- 54
- 57
- 60
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How many metres of 28mm tube are required?
- 3
- 6
- 9
- 12
- 15
- 18
- 21
- 24
- 27
- 30
- 33
- 36
- 39
- 42
- 45
- 48
- 50
- 51
- 54
- 57
- 60
Access Requirements
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Is scaffold required
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Type of scaffold required
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Cherry picker access
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Ladder access only
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External Photographs
Job Notes
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Any additional notes