Title Page

  • Company conducted

  • Conducted on

  • Prepared by

  • Location
  • Name of Gas Engineer

Service and ECV

  • Service laid to NG policy REP2

  • ECV Correct

  • Gas ON/OFF tape present

Meter and Regulator

  • Meter box correctly sited

  • Meter bracket fixed to wall/floor

  • Is internal meter positioned

  • Are Sheer off bolts fitted

  • Gas emergency number sticker fitted and readable

  • Is the regulator fitted a target regulator (SGN only)

  • Test nipple checked via LDF

  • Tightness test satisfactory

  • New/Old Reg WP correct

  • New/Old Reg WP correct

  • MPRN Label

Health and Safety WIP

  • All appropriate PPE being worn

  • Volt stick x 2 and Temp Earth Bond lead used

  • Working at heights

  • IS working at heights RA complete and all safety precaution being followed.

  • Lifting/Manual handling correct

  • Environment/waste

  • Copy of minimum standards available

  • Pipe/Cable locator used

  • Daily Risk assessment completed

  • All electrical tools within calibration/PAT date

Customer

  • Engineer shown ID

  • Comments card left with customer

New Pipework

  • Has new pipework been installed

  • Diameter and length installed

  • Is pipework straight

  • Is pipework clipped as per current standards

  • Is pipework sleeved where required

  • If pipework is sleeved is it sealed as per current standards

  • Is AECV fitted (Flats)

  • Is pipework fitted to current standards

Equipotential Bonding

  • Has cross bonding been affected

  • Where bonding is not up to current standards has bonding card been issued

  • Is clamp position satisfactory

  • Has a new bonding cable been installed

  • Length of cable installed

  • Has cable been installed satisfactory

Meter Details

  • Serial Number

  • Model

  • Manufacturer

  • Index

  • Year

  • Location

Regulator Details

  • Make

  • Model

  • Serial Number

Appliances

  • All appliances re-lit by engineer

  • Appliance code chart.JPG
  • Appliance type

  • location

  • Appliance type

  • location

  • Appliance type

  • location

  • Details of faults

  • Additional Comments

  • Any Corrective actions required

  • Inspector 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.