Title Page

  • Address
  • Conducted on

  • Engineer name

  • Engineers Name

  • Carried out by

  • Engineer Gas safe card present

  • what is expiring date

  • why not

Protocol

  • Did Engineer arrive at appointed time

  • What time did he arrive

  • Did customer receive SMS prior to appointment

  • Did Engineer indentify himself

  • Did engineer show ID card

  • Did engineer explain what work would be carried out prior to proceeding

Techincal Inspection

  • Meter Location

  • Has the engineer visually checked appliances before starting AGS

  • Did the engineer ask customer if there where any issues with appliances

  • Has the engineer checked exposed metal around meter/applliance with an approved volt stick?

  • Safe isolation must be carried out for your safety

  • Does the ECV fall to off?

  • Did the engineer follow the correct process and contact gas provider

  • CAT2 G23 ECV does not fall to off

  • Is the ECV accessible and operable?

  • Can the installation safely continue?

  • Has gas providor been notified and installation capped, warning notices issued

  • engineer to carry out works

Testing and Isolation

  • Has the engineer correctly performed the initial LET-BY test?*-

  • Why not,Evidence opertive doing this operation

  • Has the engineer correctly performed the initial TIGHTNESS TEST?

  • Was there a pressure drop?

  • is the drop within permissible limits

  • has meter been capped and work order raised, warning notice issued

  • Engineer to continue with AGS

  • evidence operative doing this operation

  • Did the engineer check the Standing pressure test at meter

  • Prompt

  • record reading

  • Did the engineer carried the working pressure test at meter

  • confirm readings

  • Evidence him doing in

  • Has engineers carried AGS to satifactory Standard

  • has standing pressure test been carried on all landlords appliances

  • Have all Gas regulation 29/6 been carried out and recorded on LGSR

  • Gas Rate

  • observe engineer carring out tests

  • Have all observations been recorded on LGSR

  • Has the engineer correctly performed the final TIGHTNESS TEST?

  • Advise to carry out

  • Has the engineer correctly used LDF on the installation and carefully wiped off after

  • Advise to carry out

  • Auditor obsevations

Completion Process

  • Please provide details of any unsafe situations identified

  • Details

  • what action has been

  • What action has been taken

  • Where the engineer identified a fault with the installation, did they notify the customer and inform them of the appropriate next steps?

  • door step protocol not applied appropriately

  • Has handheld been completed correctly?

  • Data incorrectly submitted,Handheld unit incorrectly used

  • Did the engineer leave the site as found?

  • Provide details

  • Audit outcome

  • reason failure

  • Have you provided any coaching during the site visit?

  • Please provide any good feedback observed during the site visit

  • Signed by Engineer

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.