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Safety checks · SC-09

Gas Appliance Safety Check Record

A free printable gas appliance check record — the appliances listed once, then each visit: engineer, company, registration number, date, what was found and where the document is filed.

First page of the Gas Appliance Safety Check Record — Keep your own index of who came to the gas appliances and when, so the right certificate can be found without going through a drawer of paperwork.
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One page. Choose your paper size — both versions are laid out identically, so neither one gets shrunk to fit.

Print it and write on it

Fill it in type and save

The fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.

What this sheet is for

Keep your own index of who came to the gas appliances and when, so the right certificate can be found without going through a drawer of paperwork.

Who it is for

Landlords, homeowners, letting agents, hall committees and anyone responsible for gas appliances in a property.

How to use it

  1. List each appliance once with its location, make, model and serial number.
  2. After each visit, record the date, the engineer's name and their company.
  3. Write down the registration number shown on the engineer's card.
  4. Summarise what they found in their own words, and note the document reference.
  5. Write where the certificate or report has been filed, on paper or on a drive.

What is on the sheet

One page, top to bottom:

Printed under the title: Which gas appliances were checked, by whom, under what registration number, and what they wrote down as having been found.

An index to their paperwork. Work on gas appliances belongs to a registered engineer, and the paperwork they issue is the record that counts. This sheet is your own index of it: who came, when, to which appliance, and where their certificate or report is filed.

Write-on lines: Property / site · Owner or manager · Started

Appliance list — fill in once for each appliance

Table, 4 rows: Appliance · Location · Make · Model · Serial or GC no.

Visit record

Table, 6 rows: Date · Appliance · Engineer · Company · Registration no. · What was found · Document ref. · Filed where

Questions

Why are there no readings or acceptance figures on this sheet?

Because a registered engineer records those on their own documentation, which is the record that counts. This sheet is an index to that paperwork, not a substitute for it.

Does keeping this satisfy any legal obligation?

This is a record you keep for yourself. What is required of you depends on the rules where you are and on what you do with the property — check those, and keep the engineer's own document safe.

What if an appliance is replaced?

Add the new one as a fresh row in the appliance list and leave the old row in place. The history of the appliance that was there still matters.

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Also in the resources library

The same subject, with a version you can fill in on screen.

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