Service & Repair Report

• Project Reference

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Telephone Number

1. Heat Pump

• Make

  NIBE

  Thermia

  Other

• Model

• Serial Number

• Picture of ID Plate

  Media

• Heat Pump Type

  Ground Source Heat Pump

  Air Source Heat Pump

• Manifold Checked for Leaks/Serviceability?

  Yes

  No

  N/A

• Freeze Protection of Glycol

2. Heating System

• Primary Heating System

  Radiators

  Underfloor Heating

  Other

  N/A

• Heat Curve

• Secondary Heating System

  Radiators

  Underfloor Heating

  Other

  N/A
4.10. SWL of plant or any lifting equipment exceeded?

• Heat Curve

3. Domestic Hot Water Storage

• Hot Water Storage

  Yes

  No

  N/A
4.5. Lack of daily inspection protocol?

• Model

• Serial Number

• Cylinder Type

  Vented

  Unvented

  Thermal Store

• Capacity (Litres)

• Legionella Protected

  Yes

  No

  N/A

4. Settings

• Outdoor Temperature

• Room Temperature

• Supply Temperature

• Return Temperature

• Hot Water Temperature

• Brine In Temperature

• Brine Out Temperature

• Heating Stop Temperature

• Hot Water Stop Temperature

• Operating Time Hot Water

• Operating Time Heating

5. Installation Details

• Correctly sized electrical supply and isolator fitted

  Yes

  No

  N/A

• All sensors connected and functional

  Yes

  No

  N/A

• Isolation Valves and Filter devices fitted

  Yes

  No

  N/A

• Unvented DHW safety devices fitted/serviceable

  Yes

  No

  N/A

• All UFH actuators/controls working

  Yes

  No

  N/A

• Heat Pump connected to Internet

  Yes

  No

  N/A

• Cooling Enabled

  Yes

  No

  N/A

Job Status

• Job Complete

  Yes

  No

  N/A

• Parts required

  Yes

  No

  N/A

• Invoice required

  Yes

  No

  N/A
Parts / Services

• Part / Service

• Cost

• Inclusive of VAT

  Select Yes No

  • Yes
  • No

• Return visit

  Yes

  No

  N/A

• Commissioned

  Yes

  No

  N/A

Corrective Actions

• Enter any corrective actions that will be undertaken

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• On site representative

  Sign

• Auditor's signature

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