Title Page
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Company conducted
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Conducted on
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Prepared by
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Location
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Name of Gas Engineer
Service and ECV
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Service laid to NG policy REP2
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ECV Correct
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Gas ON/OFF tape present
Meter and Regulator
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Meter box correctly sited
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Meter bracket fixed to wall/floor
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Is internal meter positioned
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Are Sheer off bolts fitted
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Gas emergency number sticker fitted and readable
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Is the regulator fitted a target regulator (SGN only)
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Test nipple checked via LDF
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Tightness test satisfactory
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New/Old Reg WP correct
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New/Old Reg WP correct
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MPRN Label
Health and Safety WIP
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All appropriate PPE being worn
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Volt stick x 2 and Temp Earth Bond lead used
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Working at heights
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IS working at heights RA complete and all safety precaution being followed.
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Lifting/Manual handling correct
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Environment/waste
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Copy of minimum standards available
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Pipe/Cable locator used
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Daily Risk assessment completed
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All electrical tools within calibration/PAT date
Customer
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Engineer shown ID
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Comments card left with customer
New Pipework
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Has new pipework been installed
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Diameter and length installed
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Is pipework straight
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Is pipework clipped as per current standards
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Is pipework sleeved where required
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If pipework is sleeved is it sealed as per current standards
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Is AECV fitted (Flats)
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Is pipework fitted to current standards
Equipotential Bonding
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Has cross bonding been affected
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Where bonding is not up to current standards has bonding card been issued
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Is clamp position satisfactory
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Has a new bonding cable been installed
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Length of cable installed
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Has cable been installed satisfactory
Meter Details
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Serial Number
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Model
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Manufacturer
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Index
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Year
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Location
Regulator Details
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Make
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Model
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Serial Number
Appliances
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All appliances re-lit by engineer
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Appliance type
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location
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Appliance type
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location
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Appliance type
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location
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Details of faults
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Additional Comments
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Any Corrective actions required
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Inspector Signature