Liberty Gas Quaility Audit Form

• Operative Name

• Job Number

• Contract

  Winchester City Council

  Sanctuary Housing

  Saxon Weald Housing

  Portsmouth City Council

• Reason for Audit

  Normal Scheduled Audit

  Priority Audit

  After Complaint

  After Gas Escape

  Client Request

• Audit Type

  Work in Progress

  Post Complete
• Location
  Address

• Conducted on

  Date

• Prepared by

Electrical

• Preliminary electrical checks carried out correctly.

  Yes

  No

  N/A

• Appliance/s have the correctly rated fuse.

  Yes

  No

  N/A

• RCD utilised with portable electrical tools.

  Yes

  No

  N/A

• Correct equipotential bonding and pisitioning (Gas meter).

  Yes

  No

  N/A

• Satisfactory distance from electrical wire/cables and gas pipework.

  Yes

  No

  N/A

Gas meter, ECV, and gas installation

• Meter installation satisfactory.

  Yes

  No

  N/A

• Correct labels fitted.

  Yes

  No

  N/A

• Satisfactory gas pipework installation and sleeving.

  Yes

  No

  N/A

Testing

• Satisfactory tightness test.

  Yes

  No

  N/A

• Satisfactory meter regulator working pressure.

  Yes

  No

  N/A

• Satisfactory appliance inlet pressure.

  Yes

  No

  N/A

Operational Checks And Inspections

• Flue route, integrity and termination.

  Yes

  No

  N/A

• Flue flow and spillage test.

  Yes

  No

  N/A

• Burner and injector.

  Yes

  No

  N/A

• Compartment ventilation (and labels).

  Yes

  No

  N/A

• Combustion air/ventilation and route.

  Yes

  No

  N/A

• CO/CO Ratio

  Yes

  No

  N/A

• Burner operating pressure.

  Yes

  No

  N/A

• Gas rate.

  Yes

  No

  N/A

• Clean/clear/undamaged heat exchanger

  Yes

  No

  N/A

• Operation of safety device.

  Yes

  No

  N/A

• Case seal (Room sealed appliances)

  Yes

  No

  N/A

• Return airpath and plenum (warm air unit)

  Yes

  No

  N/A

• Catchment space and dampers (gas fires)

  Yes

  No

  N/A

• Water flow rates and temperature set

  Yes

  No

  N/A

• System flushed and inhibitor added.

  Yes

  No

  N/A

• Compliant with manufacturer's instructions.

  Yes

  No

  N/A

Replacement and installation. Satisfactory installation/operation of

• Radiators and TVRs.

  Yes

  No

  N/A

• Condense pipe, inc pump.

  Yes

  No

  N/A

• Pressure relief pipe and route.

  Yes

  No

  N/A

• Making good and building work.

  Yes

  No

  N/A

• Cylinders, controls, tanks and filling loops.

  Yes

  No

  N/A

• Flues in voids inspection, flue sealing and route.

  Yes

  No

  N/A

• CO/Smoke alarms checked.

  Yes

  No

  N/A

• Pipework and installation lagging.

  Yes

  No

  N/A

Documentation

• Company installation documentation pack completed.

  Yes

  No

  N/A

• Warning notices correctly issued and applied.

  Yes

  No

  N/A

• Benchmark book completed correctly and issued.

  Yes

  No

  N/A

• Landlord gas safety record completed correctly and issued.

  Yes

  No

  N/A

• Cookers details recorded on landlords gas safety record.

  Yes

  No

  N/A

Health and Safety

• Engineer has up to date Health & Safety folder.

  Yes

  No

  N/A

• Engineer had an up to date copy of the company asbestos policy.

  Yes

  No

  N/A

• Safe working practices applied.

  Yes

  No

  N/A

• Compliant and safe waste disposal method.

  Yes

  No

  N/A

• Engineer qualified for work carried out.

  Yes

  No

  N/A

• Engineer wearing issued uniform.

  Yes

  No

  N/A

• Identification badge visable

  Yes

  No

  N/A

• Safety footwear being worn.

  Yes

  No

  N/A

• Required PPE being worn.

  Yes

  No

  N/A

• PPE in good condition.

  Yes

  No

  N/A

• PPE available in the van-gloves mask etc..

  Yes

  No

  N/A

• First aid kit available and stocked.

  Yes

  No

  N/A

• Fire extinguisher available and in date.

  Yes

  No

  N/A

Customer satisfaction

• Engineer possess and uses gas safe ID card.

  Yes

  No

  N/A

• Clean, tidy and protected working area/s.

  Yes

  No

  N/A

• Customer satisfied with work quality.

  Yes

  No

  N/A

• Appointed times agreed and met.

  Yes

  No

  N/A

• Engineers appearance reflects quality.

  Yes

  No

  N/A

Safe completion

• Has the appliance/installation been left safe for use.

  Yes

  No

  N/A

General comments/observations- Actions to be taken.

Inspection carried out by

• Add signature

  Sign

• Select date

  Date

Operative comments

• This is a true reflection of my work.

  Yes

  No

  N/A

• I agree to abide by the actions mentioned above.

  Yes

  No

  N/A

Operative

• Add signature

  Sign

• Select date

  Date