Lothian Heating Services Ltd - Boiler Survey

Information

• Site name

• Date

  Date

• Site address including postcode

• Contact name for maintenance

• Site phone number

• Contact mobile phone number

• Contact email

Hazards Identified

• Asbestos on site?<br>If no register and building is built before 1999 ASSUME ASBESTOS IS A RISK

  Safe

  At Risk

  N/A

• Adverse weather?

  Safe

  At Risk

  N/A

• Attic spaces?

  Safe

  At Risk

  N/A

• Chemicals / Substances

  Safe

  At Risk

  N/A

• Confined space?

  Safe

  At Risk

  N/A

• Explosion?

  Safe

  At Risk

  N/A

• Falls from height?

  Safe

  At Risk

  N/A

• Roof work?

  Safe

  At Risk

  N/A

• Falling objects?

  Safe

  At Risk

  N/A

• Fire?

  Safe

  At Risk

  N/A

• Lighting?

  Safe

  At Risk

  N/A

• Manual handling?

  Safe

  At Risk

  N/A

• Moving vehicles?

  Safe

  At Risk

  N/A

• Noise?

  Safe

  At Risk

  N/A

• Radiation?

  Safe

  At Risk

  N/A

• Lifting operations?

  Safe

  At Risk

  N/A

• Sharps?

  Safe

  At Risk

  N/A

• Services (live)?

  Safe

  At Risk

  N/A

• Slips, trips and falls?

  Safe

  At Risk

  N/A

• Public interface?

  Safe

  At Risk

  N/A

• Other trades?

  Safe

  At Risk

  N/A

• Ventilation?

  Safe

  At Risk

  N/A

• Working at height?

  Safe

  At Risk

  N/A

• Gas work?

  Safe

  At Risk

  N/A

PPE Required

• Head

• Hearing

• Hand

• Wet weather

• Body

• Foot

• Eye

• Fall arrest

• Existing boiler make and model, output and fuel

• Existing gas / oil details - location of tank or meter, diameter and length of run, type and condition of existing pipework.

• Location of existing boiler, any access issues

• Flue size, condition etc

• Condensate diameter

• Ventilation - check existing for conformity, condition, high and low level

• Controls

• Electrical details

• Builder work required?

• Photos?

• Add media

  Media

• Client

  Sign

• Engineer

  Sign