INSTALLATION, COMMISSIONING & SERVICING RECORD
TR05A140.B1107
INSTALLER & COMMISSIONING ENGINEER DETAILS
Installer Details
Company Name Installation Date
Address
CORGI Registration No. CORGI ID Serial No.
Commissioning Engineer Details (if different from Installer)
Company Name Installation Date
Address
CORGI Registration No. CORGI ID Serial No.
APPLIANCE & CONTROL DETAILS
Boiler
Make & Model
Serial No. SEDBUK Efficiency
%
Location
New System
or Replacement boiler
Controls
To comply with Building Regulations, each section must have a tick in one or more boxes
Requirement Measures Provided
1. Time and Temperature Control to Heating
Room Thermostat and
Programmer / Timer
Programmable Room
Thermostat
2. Time and Temperature Control to Hot Water
Cylinder Thermostat and
Programmer / Timer
Combi Boiler
3. Heating Zone Valves Fitted Not Required
4. Thermostatic Radiator Valves Fitted
5. Automatic Bypass to System Fitted Not Required
6. Boiler Interlock Provided
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