Title Page
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Name
- Parmjit Varraich
- Mark Skeldon
- Kyle Smith
- Balwinder Gill Singh
- Peter Clarke
- B.O.S Ste Paul Boardman
- B.O.S Chris Findler
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EUSR number
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Gas safe number
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Conducted on
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Location
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Project code
Purge & Relight Self Audit
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Arrival photo
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Meter fitted securely (add image)
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Control valve falls to a off position (add image)
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On-Off tape fitted (add image)
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Regulator to a satisfactory condition (add image)
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Seal on the regulator (add image)
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Sheer bolts applied (add image)
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EB up to standards, if not EB card left (add image)
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Emergency contact details on the meter and in good condition and east to read (add image)
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All 3 rubber washers changed (video evidence)
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Let by test 1 minute (video evidence)
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Stabilisation test 1 minutes (video evidence)
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Tightness test 2 minutes (video evidence)
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Standing pressure test
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Operating pressure test
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Have you applied LDF on all joints, nuts, nipple, unions, elbows, regulator, ECV. (mandatory) (picture evidence)
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Purge the appliances (picture evidence)
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Is the installation safe and ready for use (picture evidence)
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Has a leak been detected (pictures)
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Where is the leak detected (pictures)
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Have you informed the customer and MADE SAFE! i.e. (disk in the out let, warning notice pad, all correct danger label notices applied, proof, reported to cadent)
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Who's responsible (N/A) if not applicable
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Date and time incident recorded (N/A) if not applicable
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I agree all self audits have been carried out with 100% care and to a satisfactory standard and happy for the following operations to review and sign. Any concerns after completion I take full responsibility and rectify if needed. (signature)
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Has job been uploaded onto the hub
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Gas safe registered Engineer to review and sign (print name and sign) (add gas safe number in notes)
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FINAL SIGN OFF, Whitcombe Engineering LTD (WEL) Director to review and sign (print name and sign)
