Triangle - Technical Inspection

• Address of premises

• Date of audit

  Date

• Prepared by

Measure Inspected

• Fuel Type?

  Gas

  Oil

  Solid Fuel

  LPG

  Biomass

• Boiler Manufacturer

• Model

• Boiler/Burner Condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Boiler/Burner Location

  Select Ext Boiler House Ext Store Hallway Kitchen Hotpress Other

  • Ext Boiler House
  • Ext Store
  • Hallway
  • Kitchen
  • Hotpress
  • Other

• Flue type

  Horizontal Flue

  Vertical Flue

  Flue in void hatches

  Visible flue in attic

• Flue Condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Boiler flue properly clipped and Tapping screws fitted

  Yes

  No

  N/A

• Gas pipework condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Boiler pipework inspected - Condensate Terminated correctly

  Yes

  No

  N/A

• Boiler pipework inspected - PRV

  Yes

  No

  N/A

• Magnetic filter fitted

  Yes

  No

  N/A

• MagnaClean Condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Manufacturer

• Model

• Cylinder present?

  Yes

  No

  N/A

• Cylinder Condition?

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Room stat condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Timeclock condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Visual inspection of existing plumbing, any leaks identified?

  Yes

  No

  N/A

• Condition of pipework

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Condition of Radiatiors

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Size of Radiator(s) to be replaced?

• Number of TRVs

• Condition of TRVs

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Any TRVs missing?

  Yes

  No

  N/A

• Condition of MRVs

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Any MRVs missing?

  Yes

  No

  N/A

• Oil tank present?

  Yes

  No

  N/A

• Oil tank condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Oil tank location

• Oil pipeline condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• CO Alarms in Date?

  Yes

  No

  N/A

• Number of CO Alarms

• CO Alarm/s condition

  Very Good

  Good

  Poor

  Very Poor

  Replace

• Gas Cooker present?

  Yes

  No

  N/A

• Gas Cooker condition?

  Very Good

  Good

  Poor

  Very Poor

  Replace

Audit Summary

• Please provide details of any remedial action required:

• Audit undertaken by (Print name)

• Audit undertaken by (Signature)

  Sign

• Date

  Date