35 Chedlee Drive, Cheadle, Stockport SK8 6BQ
BOILER
00/00/00
STOP TAP
00/00/00
SMOKE ALARM
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Stop Tap Survey History
STOP TAP
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00/00/00
Last Inspection
00/00/00
Next Safety Check
N/A
Location of stop tap
N/A
Stop tap in good condition
N/A
Inspection Result
N/A
Remedial action required
SMOKE ALARM
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00/00/00
Last Inspection
00/00/00
Next Safety Check
N/A
Location - Smoke Alarm 1
N/A
Location - Smoke Alarm 2
N/A
Location - Smoke Alarm 3
N/A
Location - Smoke Alarm 4
N/A
Location - Smoke Alarm 5
N/A
Location - Smoke Alarm 6
N/A
Inspection Result
N/A
Remedial action required
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Smoke Alarm Survey History
GAS CHECKS
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Last Inspection
Next Safety Check
N/A
Meter/emergency control accessible
N/A
Visible equipotential
bonding at meter
N/A
Is gas installation
safe to use
N/A
Gas meter installation pipework satisfactory
N/A
Gas installation tightness test satisfactory
N/A
Supply fuel type
Gas/LPG
N/A
Location
N/A
Boiler type
N/A
Make
N/A
Model
N/A
Ventilation satisfactory
N/A
Flue type
N/A
Safety controls working
N/A
Flue visual check
N/A
Flue termination satisfactory
N/A
Flue integrity check
N/A
Spillage test satisfactory
N/A
Flue flow satisfactory
N/A
Working pressure/heat input
N/A
Results CO/CO2 ratio
N/A
Flue gas analysis performed
N/A
Appliance safe to use
N/A
Reason code
N/A
Warning notice to be issued
N/A
CO alarm working
N/A
Inspection result
N/A
Remedial action required
N/A
Location
N/A
Make
N/A
Model
N/A
Flue type
N/A
Safety controls working
N/A
Ventilation satisfactory
N/A
Working pressure/heat input
N/A
Warning notice to be issued
N/A
Appliance safe to use
N/A
Inspection result
N/A
Remedial action required
N/A
Location
N/A
Make
N/A
Model
N/A
Flue type
N/A
Safety controls working
N/A
Ventilation satisfactory
N/A
Working pressure/heat input
N/A
Warning notice to be issued
N/A
Appliance safe to use
N/A
Inspection result
N/A
Remedial action required
N/A
Location
N/A
Make
N/A
Model
N/A
Ventilation satisfactory
N/A
Flue type
N/A
Safety controls working
N/A
Flue visual check
N/A
Flue termination satisfactory
N/A
Flue integrity check
N/A
Spillage test satisfactory
N/A
Flue flow satisfactory
N/A
Working pressure/heat input
N/A
Appliance safe to use
N/A
Warning notice to be issued
N/A
Inspection result
N/A
Remedial action required
N/A
Engineer name
Gas Engineer Details
N/A
Company Gas Safe Reg No
N/A
Date of survey
N/A
Email for certificate copy
N/A
Gas Safe Card Serial No
I certify that I have carried out the work on the date of survey. The Customer/ Tenant/ Landlord/ Responsible Person has been informed of any faults/remedial to bring the installation(s) up to standard.
N/A
Email for certificate copy
N/A
Full Name
Resident Details
GAS SAFETY CHECKS
BOILER
HOB
OVEN
FIRE
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Boiler Survey History
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Gas Safe Certificate