Title Page

Site Details

  • SW Reference

  • Engineer

  • Sapphire Agent

  • Site Name

  • Site Address
  • Date

  • Visit Number

Boiler Details

  • Serial Number

  • Version

  • Fuel

  • KW Output

  • Firmware Version

Page 2

Combustion

  • Pressure

  • CO2

  • O2

  • CO ppm

  • Flue gas temperature

  • Air setting

  • Pressure

  • CO2

  • O2

  • CO ppm

  • Flue gas temperature

  • Air setting

  • Has combustion been checked at all pressure settings?

  • Nozzle Head

  • Thread Setting

  • Flue Draught

Parts Used

  • Part Description

  • Part Number

  • QTY

  • Serial Number

  • Part Description

  • Part Number

  • QTY

  • Serial Number

  • Part Description

  • Part Number

  • QTY

  • Serial Number

  • Part Description

  • Part Number

  • QTY

  • Serial Number

  • Part Description

  • Part Number

  • QTY

  • Serial Number

Page 3

Notes/Comments

  • Notes

Completion

  • Warning notice issued?

  • Warning notice serial number

  • Man Hours

  • Engineers signature

  • Customer Signature

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.