Title Page

  • Conducted on

  • Prepared by

  • Site / Job number

  • Plot / Unit Numbers

System Information

System Information

  • Boiler Make

  • Boiler Model

  • Boiler Serial number

  • Boiler Installed by

  • Boiler Commissioned by

  • Cylinder Make

  • Cylinder Model

  • Cylinder Serial Number

  • Cylinder Installed by

  • Cylinder commissioned by

Commissioning Documents Completed

  • Boiler

  • Cylinder

  • CP12

  • MVHR

Controls

  • Room Stat Fitted

  • Make

  • Model

  • Location fitted

  • Central Heating Programmer Fitted

  • Make

  • Model

  • Location Fitted

  • Hot Water Programmer

  • Make

  • Model

  • Location fitted

System Checks

  • System Cleansed / Flushed By

  • Amount of cleanser used (litres)

  • Inhibited by

  • Amount of inhibitor used (Litres)

  • undefined

  • Flow restrictors fitted (if applicable)

  • Locations

  • Bath Tap Set to 48 Degrees

  • TRV’s & Lockshields fitted and left in OPEN position

  • Room Stats and programmer fitted

  • ALL radiators up to temperature (set to 700c on boiler)

  • Hot water temp – Set unvented cylinder stat to 4 (four = 600c) located within electrical box – front panel

  • Hot water temp – Combi boiler – Set to 600c

  • Stop cock labelled

  • Primary circuit from boiler to cylinder insulated, including all visible pipework

  • Hot & cold water pipe from cylinder insulated a minimum of 1m-If hot return applicable – All pipework insulated and to be cable tied - NO Ducktape

  • Gas pipe sleeved

  • Mains cold water feed to cylinder – lever valve labelled

  • All cold water mains insulated (within floor / ceiling voids) – ie adjacent to HW pipe

  • Outside tap insulated and service valve to tap labelled

  • Washing machine valves correctly indexed (hot & cold) - capped if applicable

  • Inline scale reducer fitted to boiler / cylinder

  • External cage fitted to PRV & TPRV from cylinder (above gully or trap if possible)

  • Flow rates & temperature set @ 480c – Bath taps NOT to exceed this temp

  • Condense to boiler fitted correctly

  • Two (2) drain offs fitted to flow & return under boiler

  • PRV & TPRV – Tundish visible min 300mm from bottom of TD to 1st bend (G3 regs). PRV fitted at 1500mm above FFL(ext) & turned back to wall (block of flats)

  • If high temp pipework fitted between soil stack & tundish – is a HEP V O trap fitted

  • Gas cooker isolation labelled

  • Water Butts Installed & level

  • Filling loop - capped & secured to boiler

  • Gas meter labelled with correct house / flat number

  • If 2nd AECV - is it labelled, acessible, test gas point visible & directional tape fitted

  • If gas run is vertical (floor 2 ceiling & boxed in) is there sufficient ventilation

  • Gas pipework sleeved must be sealed at one end

  • Correct working pressure at meter (CP12)

  • Tracpipe ® fittings must have silicone tape on pipe & joint

  • Visual Inspection of Flue & Gasket / Seal

  • All compression fittings accessible

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.