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© Heating and Hotwater Industry Council (HHIC)
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone N
o
:
Gas Safe registration N
o
:
Max rate
CO
ppm
CO²
%
CO/CO²
Min rate
CO
ppm
CO²
%
CO/CO²
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m
3
/h
OR
ft
3
/h
delete as appropriate
Yes
No
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone N
o
:
Gas Safe registration N
o
:
Max rate
CO
ppm
CO²
%
CO/CO²
Min rate
CO
ppm
CO²
%
CO/CO²
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m
3
/h
OR
ft
3
/h
delete as appropriate
Yes
No
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
SERVICE & INTERIM BOILER WORK RECORD
It is recommended that your boiler and heating system are regularly serviced and maintained, in line with manufacturers’ instructions, and that the appropriate service /
interim work record is completed.
Service provider
When completing a service record (as below), please ensure you have carried out the service as described in the manufacturers’ instructions. Always use the
instructions and BS 7593. It is only acceptable to not have undertaken this if the service engineers
attendance visit was in between annual services to attend a non-water facing component.
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone N
o
:
Gas Safe registration N
o
:
Max rate
CO
ppm
CO²
%
CO/CO²
Min rate
CO
ppm
CO²
%
CO/CO²
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m
3
/h
OR
ft
3
/h
delete as appropriate
Yes
No
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
instructions and BS 7593. It is only acceptable to not have undertaken this if the service engineers
attendance visit was in between annual services to attend a non-water facing component.
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone N
o
:
Gas Safe registration N
o
:
Max rate
CO
ppm
CO²
%
CO/CO²
Min rate
CO
ppm
CO²
%
CO/CO²
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m
3
/h
OR
ft
3
/h
delete as appropriate
Yes
No
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
instructions and BS 7593. It is only acceptable to not have undertaken this if the service engineers
attendance visit was in between annual services to attend a non-water facing component.
instructions and BS 7593. It is only acceptable to not have undertaken this if the service engineers
attendance visit was in between annual services to attend a non-water facing component.
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone N
o
:
Gas Safe registration N
o
:
Max rate
CO
ppm
CO²
%
CO/CO²
Min rate
CO
ppm
CO²
%
CO/CO²
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m
3
/h
OR
ft
3
/h
delete as appropriate
Yes
No
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
instructions and BS 7593. It is only acceptable to not have undertaken this if the service engineers
attendance visit was in between annual services to attend a non-water facing component.
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone N
o
:
Gas Safe registration N
o
:
Max rate
CO
ppm
CO²
%
CO/CO²
Min rate
CO
ppm
CO²
%
CO/CO²
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m
3
/h
OR
ft
3
/h
delete as appropriate
Yes
No
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
instructions and BS 7593. It is only acceptable to not have undertaken this if the service engineers
attendance visit was in between annual services to attend a non-water facing component.