Title Page

  • Conducted on

  • Prepared by

  • Line

  • Job Number

  • Serial Number

Appliances Serial Numbers

  • Washing Machine

  • Dish Washer

  • Fridge

  • Freezer

  • Fridge/Freezer

  • Oven

  • Hob

  • Extractor

Chassis

  • ID Number

  • Date of Chassis Manufacture

  • Weight Band

  • Number of Axles

  • Axel Distances

  • Chassis Labels

  • Hold Down Points

External

  • Correct ID on Chassis Label

  • Vertical Flue. Roof Slate Fitted

  • Horizontal Flue Fitted

  • Flue> 300mm From Openings

  • Drain Off Location

  • Gas and Water Pipe Ends Sealed

Kitchen/Utility

  • Kitchen Extractor Outlet

  • Utility Extractor Outlet

  • Boiler Gas Drop And Mesh Grill

  • Boiler Gas Feed Sleeved and Sealed Through Floor

  • Pipework Sealed Through Flooring

  • Inspection Hatch For Vertical Flue

  • Gas and Fire Safety Notice

  • Stop Cock

  • Waste Traps

  • Hob Extractor. Min Height From Hob 700mm for gas. 650mm for electric

  • Oven

  • Appliance Ventilation

  • Hob and Fuel Type

  • Masterboard Below Gas Hob

  • Hob Gas Drop And Nesh Grill

  • Hob Gas Feed Sleeved Through Floor. Sealed.

  • Gas Drop Holes Cut In Drawers Where Gas Pipework Is Present

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Lounge/Diner

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Utility-Separate

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Bedroom 1

  • Bed and Mattress Labels

  • Headboard Labels

  • Cabin Bed Safety Label

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Bedroom 2

  • Bed and Mattress Labels

  • Headboard Labels

  • Cabin Bed Safety Label

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Bedroom 3

  • Bed and Mattress Labels

  • Headboard Labels

  • Cabin Bed Safety Label

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Bedroom 4

  • Bed and Mattress Labels

  • Headboard Labels

  • Cabin Bed Safety Label

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Study

  • Furniture Labels

  • Means of Escape Windows/ Min 450mm (x740mm)

  • Personnel Doors/ Min 700mm (x 1900mm)

  • Number of Trickle Vents

  • Safety Glass in Windows Adjacent to Doors

  • K/Glass

  • Safety Glass. Internal Partitioning/Panels/Doors

  • Air Gap Under Internal Door

Bathroom

  • Retaining Clip Fitted To Shower Hose

  • Thermostatic Mixing Valves

  • Safety Glass

  • Extraction

  • Waste Traps

  • 6Ltr Stamped in Cistern

  • Air Gap Under Internal Door

Ensuite 1

  • Retaining Clip Fitted To Shower Hose

  • Thermostatic Mixing Valves

  • Safety Glass

  • Extraction

  • Waste Traps

  • 6Ltr Stamped in Cistern

  • Air Gap Under Internal Door

Ensuite 2

  • Retaining Clip Fitted To Shower Hose

  • Thermostatic Mixing Valves

  • Safety Glass

  • Extraction

  • Waste Traps

  • 6Ltr Stamped in Cistern

  • Air Gap Under Internal Door

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.