Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Boiler Replacement Address Details
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Date Of The Boiler Replacemeant
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Has the Boiler Assessment Checklist been complete
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Please take a clear and in focus photo of all pages (Boiler assessment Checklist)
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Have you completed your has safety certificate (CP12)
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Please take a clear and in focus photo of you completed CP12
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Have you completed the benchmark (Gas Boiler Commissioning Checklist)
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Please take a clear and in focus photo of you completed benchmark (Gas Boiler Commissioning Checklist)
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Have you completed the Boiler Replacement Warranty - 2 Years Document
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Please take a clear and in focus photo of your completed Worksmenship
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Have you completed the Declaration of Conformity
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Brand and Model of old boiler
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Please take a clear and in focus of the Declaration of Conformity (all pages)
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Photo Of The Old Boiler In Situ
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Photo Of The Old Boiler Data Plate
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Photo Of The Old Boiler Flue Inside & Outside
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Brand & Model Of the New Boiler
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Photo Of The New Boiler In situ
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Add media
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Please Scan the new boiler barcode
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By signing this document you are confirming that all the infomation/question above have been completed