www.centralheating.co.uk
Customer name:
Telephone number:
Address:
Boiler make and model:
Boiler serial number:
Commissioned by (PRINT NAME):
Company name:
Telephone number:
Company address:
Commissioning date:
To be completedby the customer on receipt of a Building Regula
�
ons Compliance Cer
�fi
cate*
Building Regula
�
ons No
�fi
ca
�
on Number (if applicable):
CONTROLS (
�
ck the appropriate boxes)
Time and temperature control to
hea
�
ng
Room thermostat and programmer/
�
mer
Programmable room thermostat
Op
�
mum start control
Load/weather compensa
�
on
Time and temperature control to hot waterylinder thermostat and programmer/
�
mer
Combina
�
on Boiler
Hea
�
ng zone valves
Fi
�
ed
Not required
Hot water zone valves
Fi
�
ed
Not required
Thermosta
�
c radiator valves
Fi
�
ed
Not required
Automa
�
c bypass to system
Fi
�
ed
Not required
Boiler interlock
Provided
Electric connec
�
ons (
fi
ll the form)
Voltage supply to the boiler
single phase
three phase
What is the ra
�
ng of circuit breaker to the boiler?
Amps
Is the boiler supply line protected by an RCD?
Yes
What size is the cross sec
�
on of the power cord of the boiler?
mm
²
Have all mains connec
�
ons been checked for
�
ghtness?
Yes
Has a clamp meter test been carried out to verify the power ra
�
ng?
Yes
No
Has the electrical installa
�
on been tested and cer
�fi
ed?
Yes
The system has been installed and commissioned in accordance with the manufacturer’s instruc
�
ons
Yes
ALL SYSTEMS
The system has been
fl
ushed and cleaned in accordance with BS7593 and boiler manufacturer's instruc
�
ons
Yes
What system cleaner was used?
What inhibitor was used?
Quan
�
ty
litres
Has a primary water system
fi
lter been installed?
Yes
No
CENTRAL HEATING MODE
measure and record:
Maximum capacity current per phase
Amps
Central hea
�
ng
fl
ow temperature
°C
Central hea
�
ng return temperature
°C
COMBINATION BOILERS ONLY
Is the installa
�
on in a hard water area (above 200ppm)?
Yes
No
If yes, and if required by the manufacturer, has a water scale reducer been
fi�
ed?
Yes
No
DOMESTIC HOT WATER MODE
Measure and Record:
Maximum capacity current per phase
Amps
Cold water inlet temperature
°C
Hot water has been checked at all outlets
Yes
Temperature
°C
Water
fl
ow rate
I/min
ALL INSTALLATIONS
The hea
�
ng and hot water system complies with the appropriate Building Regula
�
ons
Yes
The boiler and associated products have been installed and commissioned in accordance with the manufacturer’s instruc
�
onsYes
The opera
�
on of the boiler and system controls have been demonstrated to and understood by the customer
Yes
The manufacturer’s literature, including Benchmark Checklist and Service Record, has been explained and le
�
with the customYes
Commissioning Engineer’s Signature
Customer’s Signature
(To con
fi
rm sa
�
sfactory demonstra
�
on and receipt of manufacturer' literature)
*All installations in England and Wales must be
to Local Authority Building Control (LABC) either directly or through a
Competent Persons Scheme. A Building Regulations Compliance
will then be issued to the customer.
©
H
eating and
H
otwater Industry Council (
HH
IC
)
ELECTRIC
BO
I
LER
SYSTEM
COMM
I
SS
I
ON
I
NG
CHECKL
I
ST
Th
i
s
Comm
i
ss
i
on
i
ng
Check
li
st
i
s
to
be
comp
l
eted
i
n
f
u
ll
by
the
competent
person
who
comm
i
ss
i
oned
the
bo
il
er
as
a
means
o
f
demonstrat
i
ng
comp
li
ance
w
i
th
the
appropr
i
ate
Bu
il
d
i
ng
Regu
l
at
i
ons
and
then
handed
to
the
customer
to
keep
f
or
f
uture
re
f
erence.
Failure to install and commission according to the manufacturer’s instructions and complete this Benchmark Commissioning Checklist will invalidate the
warranty. This does not affect the customer’s statutory rights.
www.centralheating.co.uk
42