Landlord Gas Safety Record Cert. No.

491

Safety Inspection and reporting carried out in accordance with the Gas Safety (Installation and Use) Regulations and the Gas Industry Unsafe
Progas Letting Solutions Ltd Situations Procedure.

Company / Installer Job Address Customer / Landlord

Engineer Billy Looker Name Mr Thanasoulas Name
Company Address Company Foxtons
Progas Letting Solutions Ltd 6 Barton court
Address Address 55
25 Barons Court Road
Lodge Way Fulham Broadway
Ashford, Surrey London Fulham
Post Code W14 9EH London
Post Code TW153AH Tel. No Post Code SW6 1AE
Tel No. 07833206710 Tel. No
Gas Safe Reg 556226
ID Card No.

Appliance Details Inspection Details

Location Appliance Type Make Model Flue Type Landlord's Appliance Inspected Operating Pressure Heat Input (kW/h) High Combustion Low Combustion Safety device(s) Ventilation Visual condition Flue Appliance Appliance safe
Appliance (mbar) Reading Reading correct Provision of flue and Performance Serviced to use
operation satisfactory termination test
Ratio CO CO2 Ratio CO CO2
satisfactory
ppm % ppm %

1 KITCHEN Boiler Worcester Greenstar 12i System RS Yes Yes 20mb 12kw 0.0007 72 9.2 0.0004 41 8.6 Yes Yes Yes Pass No Yes
2 KITCHEN Hob Unknown Unknown FL Yes Yes 20mb 7kw NA NA NA NA NA NA Yes Yes NA NA No Yes
3 Lounge Fire Unknown Unknown OF Yes Yes 20mb 6.9kw NA NA NA NA NA NA Yes Yes Yes Pass No Yes
4
5
6
Defects / Identified Labels and Warning Notice Issued CO Alarm(s) Smoke Alarm(s)
1 No
2 No CO Alarm(s) fitted No Smoke Alarm(s) fitted Yes
3 No
4 CO Alarm(s) tested Smoke Alarm(s) tested
Fail Pass
5 and Satisfactory and Satisfactory
6

Emergency Control Accessible Yes Gas Tightness Satisfactory Yes Comments

Gas Installation Pipework Visual Inspection Satisfactory Yes Meter kitchen cupboard

Equipotential Bonding Yes

NEXT INSPECTION DUE ON OR 04-Dec-2021

BEFORE

Signatures
Issued by: Signed Received Signed Date 24-Nov-2020
by:

Print Name Billy Looker Print Name Mr Thanasoulas