Information
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Document No.
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Job Title
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Account Name
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Postal Address
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Name of Client
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Site Address
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Or GPS locate the site address
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Customer Description
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Contact
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Description of Job
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Date Received
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Site assessment with construction plans & task analysis
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Mark out gas appliance location & flue pathways
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Discuss technical detail and compliance with Owner/Builder
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Install gas pipework & pressure test to
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KPa
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Install gas appliance as per specific instructions
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Leak test gas pipework to
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KPa
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Commission & certify to AS/NZS 5601:2010
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Date Started
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Date Completed
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Order Number
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Quote/Estimate
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Tax Invoice Number
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Home
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Work
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Mobile
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Mobile 2
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Fax
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Email
Gas Appliance Markings
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Make
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Model
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Serial Number
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Isolating Valve
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Clearances
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Flue Type
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Flue Position
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Appliance Pressure
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Appliance Pressure High
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Appliance Pressure Low
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Input Rating
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Commissioned
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Ventilation
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Combustion
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Seismic Restraint
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Date of Install
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Gas Certification Number
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Category
- Domestic
- Commercial
- Industrial
- Mobile
- Temporary
- Electrical
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Type
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Gas Supplier
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Labelled
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Test Pressure
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Test Time
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Nil Leak Tolerance
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Regulators
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Auto
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Manual
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LP-HP
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First Stage
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Second Stage
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Appliance Reg
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Sign Initials
Customer Declaration (Optional)
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I authorise this contractor to carry out the work as detailed on this form. I understand that no significant additional work will be undertaken without my authorisation and I accept the terms and conditions. I will settle payment by:
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Card Number
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Expiry Date
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Customers Signature
Ventilation Requirements
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For further information see ASNZS 5601:2010, Ventilation requirements, parts 1 & 2
In brief:
- 1.6.4 Ventilation shall ensure proper operation of the gas appliance and flueing system and maintain safe ambient conditions
- 2.2.6 Where a gas appliance is installed in a room, that room shall be ventilated
- Where the total input of open flued appliance exceeds 3MJ/hr for each cubic metre of room volume, the area shall be ventilated
- Where the total input of open flued appliance does not exceed 3MJ/hr per cubic metre of room volume, the required air may be provided by adventitious openings, ie gaps around doors and windows
- to establish whether the required air is to be provided by adventitious openings or additional openings. Calculate the total input of the gas appliance or appliance in the room in MJ/hr and divide by the room volume in cubic metres -
Total gas input MJ/HR
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Divided by
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Room Volume m3 L x W x H
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X
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X
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= m3
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= MJ per cubic metre
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2.6.6.1 Natural ventilation. Two permanent openings shall be provided each with a minimum free area as calculated using:
A = FxT formula
A = Minimum free area mm square
F = Factor given in table 13
T = Total gas consumption of all gas appliances -
Adventitious Ventilation
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Additional Ventilation Required
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Checked
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Initials
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Drawings
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Gascraft Engineering Ltd
PO Box 3176, Christchurch
Requirements for Pipesizing
- Calculate the total Gas consumption required in mj/hr
- Calculate the developed length of pipework in metres & label the start point and branch connections points alphabetically
- Indicate type of Gas utlised
- Select pipework material & determine the premissable drop ie: LP gas - 0.25
- Outline a schematic drawing of proposed pipework
- Use AS/NZS 5601:2010 Pipesizing tables -
Pipe Section
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Length M
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Gas Flow MJ
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Pipe Size MM
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Completion of Work and Job Card
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Signature of Technician
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Date
Commissioning and Final Testing Checks (normal operating conditions)
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Troubleshooting and Fault Finding
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Have you remedied the ...
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What is the Root Cause of this failure or breakdown?
Completion of Work & Job Card
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Signature of Technician
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Date Signed