Information
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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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Date & time
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Address details
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Type of appliance ?
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Make and model of appliance
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Flue type
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Visual condition of appliance/flue termination acceptable
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Satisfactory flue flow test
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Satisfactory spillage test
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Gas pipe work satisfactory
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Tightness test satisfactory
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Earth bonding satisfactory
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Appliance safe to use
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Recommend replacement of appliance
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LDF used on test points
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RCD fuse box fitted
