Gas Safety ChecksPlease enable JavaScript in your browser to complete this form. - Step 1 of 10ClientAddressDatePhoto of PropertyProperty TypeN/ARental PropertyRooming HouseNextAppliance #1 detailsIs the installation gastight in accordance with AS/NZS5601.1? N/AYESNOIs the appliance and its components accessible for servicing and adjustment?N/AYESNOWhere required by AS/NZS5601.1 is an isolation valve provided at the inlet connection of the appliance?N/AYESNOIs the appliance and its installation electrically safe? (Note: Electrical safety is confirmed by checking the electrical supply is isolated, checking earth continuity, checking insulation resistance (where applicable) and using bonding straps if disconnecting an appliance) N/AYESNOIs there evidence of certification? (AGA, SAI -Global, IAPMO, Global-Mark or BSI). (Record in the observations table if there is no evidence of certification).N/AYESNOWhere applicable are gas appliances including cookers adequately restrained from tipping over?N/AYESNOIs the room ventilation adequate for the installed appliances? (consider installation and building date for applicable requirements)N/AYESNOWhere visible are clearances from combustible surfaces in accordance with the installation instructions and AS/NZS5601.1?N/AYESNOWhere applicable is the cowl, chimney plate or flue terminal in good condition and clear of obstruction?N/AYESNOWhere applicable is the flue adequately supported and correctly installed (i.e. terminal has correct clearance distance) and sealed at roof penetration?N/AYESNOWhere applicable is the flue, or its surroundings, clear of signs of scorching or overheating?N/AYESNOWhere applicable is the heat exchanger in good condition (test for spillage of combustion products)N/AYESNOHas the appliance been cleaned of dust and debris (e.g. burner, pilot, fan, filters, air intake)?N/AYESNOAre gas supply and burner operating pressures correct? (Note: All appliances must be operating)N/AYESNOIs the appliance clean of dust and debris (e.g. burner, pilot, fan, filters, air intake)N/AYESNOAre burner flames normal? (i.e. no evidence of flame lifting, floating, yellow tipping or sooting)N/AYESNOIs the appliance operating correctly including safety devices such as pressure and temperature relief valves?N/AYESNOIf applicable, is the Hot Water Service tempering valve installed and functioning?N/AYESNOFile UploadSelect medium qualityPreviousNextWould you like to add a second applianceN/AYESNOAppliance #2 detailsIs the installation gastight in accordance with AS/NZS5601.1?N/AYESNOIs the appliance and its components accessible for servicing and adjustment?N/AYESNOWhere required by AS/NZS5601.1 is an isolation valve provided at the inlet connection of the appliance?N/AYESNOIs the appliance and its installation electrically safe? (Note: Electrical safety is confirmed by checking the electrical supply is isolated, checking earth continuity, checking insulation resistance (where applicable) and using bonding straps if disconnecting an appliance)N/AYESNOIs there evidence of certification? (AGA, SAI -Global, IAPMO, Global-Mark or BSI). (Record in the observations table if there is no evidence of certification).N/AYESNOWhere applicable are gas appliances including cookers adequately restrained from tipping over?N/AYESNOIs the room ventilation adequate for the installed appliances? (consider installation and building date for applicable requirements)N/AYESNOWhere visible are clearances from combustible surfaces in accordance with the installation instructions and AS/NZS5601.1?N/AYESNOWhere applicable is the cowl, chimney plate or flue terminal in good condition and clear of obstruction?N/AYESNOWhere applicable is the flue adequately supported and correctly installed (i.e. terminal has correct clearance distance) and sealed at roof penetration?N/AYESNOWhere applicable is the flue, or its surroundings, clear of signs of scorching or overheating?N/AYESNOWhere applicable is the heat exchanger in good condition (test for spillage of combustion products)N/AYESNOHas the appliance been cleaned of dust and debris (e.g. burner, pilot, fan, filters, air intake)?N/AYESNOAre gas supply and burner operating pressures correct? (Note: All appliances must be operating)N/AYESNOIs the appliance clean of dust and debris (e.g. burner, pilot, fan, filters, air intake)N/AYESNOAre burner flames normal? (i.e. no evidence of flame lifting, floating, yellow tipping or sooting)N/AYESNOIs the appliance operating correctly including safety devices such as pressure and temperature relief valves?N/AYESNOIf applicable, is the Hot Water Service tempering valve installed and functioning?N/AYESNOFile UploadSelect medium qualityPreviousNextWould you like to add a third applianceN/AYESNOAppliance #3 detailsIs the installation gastight in accordance with AS/NZS5601.1?N/AYESNOIs the appliance and its components accessible for servicing and adjustment?N/AYESNOWhere required by AS/NZS5601.1 is an isolation valve provided at the inlet connection of the appliance?N/AYESNOIs the appliance and its installation electrically safe? (Note: Electrical safety is confirmed by checking the electrical supply is isolated, checking earth continuity, checking insulation resistance (where applicable) and using bonding straps if disconnecting an appliance)N/AYESNOIs there evidence of certification? (AGA, SAI -Global, IAPMO, Global-Mark or BSI). (Record in the observations table if there is no evidence of certification).N/AYESNOWhere applicable are gas appliances including cookers adequately restrained from tipping over?N/AYESNOIs the room ventilation adequate for the installed appliances? (consider installation and building date for applicable requirements)N/AYESNOWhere visible are clearances from combustible surfaces in accordance with the installation instructions and AS/NZS5601.1?N/AYESNOWhere applicable is the cowl, chimney plate or flue terminal in good condition and clear of obstruction?N/AYESNOWhere applicable is the flue adequately supported and correctly installed (i.e. terminal has correct clearance distance) and sealed at roof penetration?N/AYESNOWhere applicable is the flue, or its surroundings, clear of signs of scorching or overheating?N/AYESNOWhere applicable is the heat exchanger in good condition (test for spillage of combustion products)N/AYESNOHas the appliance been cleaned of dust and debris (e.g. burner, pilot, fan, filters, air intake)?N/AYESNOAre gas supply and burner operating pressures correct? (Note: All appliances must be operating)N/AYESNOIs the appliance clean of dust and debris (e.g. burner, pilot, fan, filters, air intake)N/AYESNOAre burner flames normal? (i.e. no evidence of flame lifting, floating, yellow tipping or sooting)N/AYESNOIs the appliance operating correctly including safety devices such as pressure and temperature relief valves?N/AYESNOIf applicable, is the Hot Water Service tempering valve installed and functioning?N/AYESNOFile UploadSelect medium qualityPreviousNextWould you like to add a fourth applianceN/AYESNOAppliance #4 detailsIs the installation gastight in accordance with AS/NZS5601.1?N/AYESNOIs the appliance and its components accessible for servicing and adjustment?N/AYESNOWhere required by AS/NZS5601.1 is an isolation valve provided at the inlet connection of the appliance?N/AYESNOIs the appliance and its installation electrically safe? (Note: Electrical safety is confirmed by checking the electrical supply is isolated, checking earth continuity, checking insulation resistance (where applicable) and using bonding straps if disconnecting an appliance) N/AYESNOIs there evidence of certification? (AGA, SAI -Global, IAPMO, Global-Mark or BSI). (Record in the observations table if there is no evidence of certification).N/AYESNOWhere applicable are gas appliances including cookers adequately restrained from tipping over?N/AYESNOIs the room ventilation adequate for the installed appliances? (consider installation and building date for applicable requirements)N/AYESNOWhere visible are clearances from combustible surfaces in accordance with the installation instructions and AS/NZS5601.1?N/AYESNOWhere applicable is the cowl, chimney plate or flue terminal in good condition and clear of obstruction?N/AYESNOWhere applicable is the flue adequately supported and correctly installed (i.e. terminal has correct clearance distance) and sealed at roof penetration?N/AYESNOWhere applicable is the flue, or its surroundings, clear of signs of scorching or overheating?N/AYESNOWhere applicable is the heat exchanger in good condition (test for spillage of combustion products)N/AYESNOHas the appliance been cleaned of dust and debris (e.g. burner, pilot, fan, filters, air intake)?N/AYESNOAre gas supply and burner operating pressures correct? (Note: All appliances must be operating)N/AYESNOIs the appliance clean of dust and debris (e.g. burner, pilot, fan, filters, air intake)N/AYESNOAre burner flames normal? (i.e. no evidence of flame lifting, floating, yellow tipping or sooting)N/AYESNOIs the appliance operating correctly including safety devices such as pressure and temperature relief valves?N/AYESNOIf applicable, is the Hot Water Service tempering valve installed and functioning?N/AYESNOFile UploadSelect medium qualityPreviousNextIs there any LPG cylinders or associated components?N/AYESNOAre cylinders installed on a firm, level and non-combustible base, and not resting on soil?N/AYESNOAre LP Gas cylinders suitably restrained and have compliant clearances?N/AYESNOAre hoses, pigtail and fittings in good condition and not degraded or work hardened?N/AYESNOAre pressure regulators correctly fitted, orientated, set and complete?N/AYESNOPreviousNextAppliance #1 Negative Pressure TestNegative pressure test (open flued appliances only) - Was there a negative pressure?N/AYESNOSpillage test - Was there spillage of combustion products?N/AYESNOAdd a second negative pressure test?N/AYESNOAppliance #2 Negative Pressure TestSpillage test - Was there spillage of combustion products?N/AYESNONegative pressure test (open flued appliances only) - Was there a negative pressure?N/AYESNOAdd a third negative pressure test?N/AYESNOAppliance #3 Negative Pressure TestSpillage test - Was there spillage of combustion products?N/AYESNONegative pressure test (open flued appliances only) - Was there a negative pressure?N/AYESNOPreviousNextAdd photo of supply negative pressure testPreviousNextObservations and identified faults.Remedial action to be taken.PreviousNextInspector DetailsNameLicense NumberOverall PASS/FAILSelectPASSNON COMPLIANTUNSAFENext Test DueSignatureClear SignatureFinish