Gas Safety Certificate Page No 1 of 1

Ref: Cooker installation

Date: 18/12/2022 Unique Serial No: 78427339 Gas Safe Reg No: 637336

Customer Address Site Details Registered Business Details

Name: Mrs Linda Lako Name: Mrs Linda Lako Name: JW Plumbing & Heating
40 Moorside South 40 Moorside South 7 Charlotte Street
Address: Address: Address:
Newcastle upon Tyne Newcastle upon Tyne Wallsend
Postcode: NE4 9BB Postcode: NE4 9BB Postcode: NE28 7PT
Telephone: Mobile: Telephone: Mobile: Telephone: 07599583344

Appliance Details Inspection Details

Operating Safety
Landlord's Ventilation Smoke Pellet Satisfactory Flue Visual
Appliance Pressure in device(s) Spillage Test Appliance Appliance
Appliance Appliance (if provision Flue Flow Termination Condition
Location Make Model Flue Type Inspected mbars or correct Pass / Fail / serviced safe to use
Type applicable) satisfactory Test Pass / Pass / Fail / Pass / Fail /
Yes/No heat input operation NA Yes/No Yes/No
Yes/No/NA Yes/No Fail / NA NA NA
kW/h Yes/No

1 kitchen Cooker Rangemaster classic deluxe 100 duel fuel FL No Visual Inspection Only - No physical checks were undertaken. Yes or No Safe To Use is based on obvious physical defects Yes

2
3
4
5
6

Defects Identified Remedial Action Taken Combustion Analysis Readings

1st Reading Min/Low 2nd Readings/Max/High 3rd Reading DHW
CO CO2 Ratio CO CO2 Ratio CO CO2 Ratio
1 Visual Inspection Only
2
3
4
5
6

Final Checks Sign-Off Flue Types Key

Gas Tightness Test initial FL-Flueless
20.00 TT final value: 20.00
value:
This safety record is issued OF-Open Flue
Satisfactory gas tightness test Yes/No/NA: Yes by: RS-BF-Room sealed balanced flue
Gas installation pipework satisfactory visual inspection Yes/No: Yes
RS-FF-Room sealed fan flue
Emergency Control accessible Yes/No: Yes
Gas Operative John Wells NEXT SAFETY CHECK DUE BEFORE 19/12/2023
Main Protective Equipotential Bonding satisfactory Yes/No: Yes
Date 18/12/2022
CO alarm CO alarm
Na Na In date? Na
present? working?
Extended gas pipe and fitted new bayonet with micro hose connection. Gas tightness and
Smoke alarm(s) present? Na Smoke alarm(s) working? Na safety tests carried out. Wired up from fuse spur wire.
Received by Customer is not present