Title Page
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Conducted on
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Prepared by
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Location
Homeowner/Tenant details
Name
Address
Telephone No:
Ref No
Installer
Installation Date
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Select date
Final Inspection Date
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Select date
QAA Date
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Select date
QAA Inspectors Name
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UNSAFE SITUATIONS: ID Yes/No AR Yes/No RIDDOR
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If Yes, name person at HO informed by phone
System Installation
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Does the percentage of the measure installed match the specification?
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Have all injection holes been filled?
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Have all injection holes been finished to an aesthetically acceptable standard?
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Are combustion vents/flues/chimneys clear of insulation and in compliance with HSE/CIGA Guidance?
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Have combustion air core vents been fitted where required?
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Have cavity brushes been fitted where appropriate?
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Has all access equipment i.e. Scaffolding been removed from site?
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Are there any other health and safety issues related to the installation?
Fire Detection to meet requirements of BS5839- Grade F:Cat LD2
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Lounge & Kitchen (Heat detection)
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Upper & Lower Hall forming escape routes (Smoke detection)
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Carbon Monoxide/Dioxide Alarm installed to manufacturers instructions
Customer Documents
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System documentation & CWI installation completion certificate/s left with documents
Customer Care
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Contact & Punctuality of Surveyors/Installers/Inspectors
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Polite & Professional team -Surveyors/Installers/Inspectors
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Care of customer property/damages (has the customer advised WW)
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Is the customer competent on using the system controls
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Does the customer know what to do in case of an emergency
Customer Care Cont'd
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Did the customer receive advise on fuel tariff's
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Contact details left for Warmwork's
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Assistance moving furniture and lifting carpets (where specified)
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Have all redundant materials been removed
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Installation neat and tidy
SCHEME COMPLIANCE
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All Measures Installed as expected
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Works previously QA'd by National Scheme manager's Assessor
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Inspection Feedback/comments/concerns if any:
SIGNATURES
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Customer signature is required only to confirm that a Quality Assurance Inspector has visited a property and carried out a visual inspection
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Does the customer have a complaint issues?
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Complaint Details
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Customer signature Print name
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QAA Inspectors Signature Print name
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Emergency calls to be logged to Pennington 01928 568842 & XXXX FIELD SERVICE MANAGER (NEST) TEL NO XXXX FIELD SERVICE MANAGER (ARBED) TEL NO