© Heating and Hotwater Industry Council (HHIC)
www.centralheating.co.uk
* All installations in England and Wales must be notified to Local Authority Building Control (LABC) either directly or through a
Competent Persons Scheme. A Building Regulations Compliance Certificate will then be issued to the customer.
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
manufacturers specified spare parts.
SERVICE/INTERIM WORK ON BOILER
delete as appropriate
Date:
Engineer name:
Company name:
Telephone No:
Gas Safe registration No:
Max rate CO ppm CO
² %
CO/CO
²
Min rate CO ppm CO
² %
CO/CO
²
Where possible, has a flue integrity check been
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m3/h
OR
ft3/h
Were parts fitted?
delete as appropriate
Yes
No
Parts fitted:
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
*A System inhibitor efficacy test is required on every annual service in accordance with the manufacturers
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.
*A System inhibitor efficacy test is required on every annual service in accordance with the manufacturers
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.
*A System inhibitor efficacy test is required on every annual service in accordance with the manufacturers
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.
*A System inhibitor efficacy test is required on every annual service in accordance with the manufacturers
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.
*A System inhibitor efficacy test is required on every annual service in accordance with the manufacturers
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.
*A System inhibitor efficacy test is required on every annual service in accordance with the manufacturers
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 No:
Gas Safe registration No:
Max rate CO ppm CO
² %
CO/CO
²
Min rate CO ppm CO
² %
CO/CO
²
Where possible, has a flue integrity check been
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m3/h
OR
ft3/h
Were parts fitted?
delete as appropriate
Yes
No
Parts fitted:
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 No:
Gas Safe registration No:
Max rate CO ppm CO
² %
CO/CO
²
Min rate CO ppm CO
² %
CO/CO
²
Where possible, has a flue integrity check been
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m3/h
OR
ft3/h
Were parts fitted?
delete as appropriate
Yes
No
Parts fitted:
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 No:
Gas Safe registration No:
Max rate CO ppm CO
² %
CO/CO
²
Min rate CO ppm CO
² %
CO/CO
²
Where possible, has a flue integrity check been
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m3/h
OR
ft3/h
Were parts fitted?
delete as appropriate
Yes
No
Parts fitted:
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 No:
Gas Safe registration No:
Max rate CO ppm CO
² %
CO/CO
²
Min rate CO ppm CO
² %
CO/CO
²
Where possible, has a flue integrity check been
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m3/h
OR
ft3/h
Were parts fitted?
delete as appropriate
Yes
No
Parts fitted:
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 No:
Gas Safe registration No:
Max rate CO ppm CO
² %
CO/CO
²
Min rate CO ppm CO
² %
CO/CO
²
Where possible, has a flue integrity check been
undertaken in accordance with manufacturers’
instructions, and readings are correct?”
yes
Gas rate:
m3/h
OR
ft3/h
Were parts fitted?
delete as appropriate
Yes
No
Parts fitted:
System inhibitor concentration has been checked and
appropriate action taken, in accordance with BS 7593
and boiler manufacturers’ instructions. *
yes
n/a
Comments:
Signature:
