Broseley eVolution - Commissioning Form

Endure Balanced Flue 21
Commissioning Form
THIS SECTION MUST BE COMPLETED AND SIGNED BY THE INSTALLATION
ENGINEER
PLEASE LEAVE WITH THE CUSTOMER AND THE APPLIANCE.
Size of Governor setting: (i.e.) Natural Gas 20mbar.
Length and size of gas supply: _______________
Meter pressure Fire only on: ________________
Meter pressure with all other appliances on: __________________
Burner pressure Fire only on: _______________
Burner pressure with all other appliances on: __________________
Gas rate - Natural Gas - Time for 1 cubic foot in seconds: ___________
Top or Rear Flue Installation: _________ Overall length of flue: __________
Is there any spillage: __________Is the draught excessive: __________
Is there any permanent ventilation in the room: ____________________
Is the TTB connected correctly (both ends): ______________
Is the aeration of the pilot correct: __________
Does the flame encircle the Thermocouple: ___________
Installation Engineers Name:
_____________________________________________________
Installers __________________________________
Address __________________________________
__________________________________
__________________________________
Post Code: ______________________________________
Telephone: __________________
Fax:_________________Mobile:___________________Other:
Gas Safe Registration No:
_______________________________________________________
Signed: ___________________________________ Date: _________________