An engineer's record of the annual service of one boiler: appliance, fuel and flue type, a visual check of the installation, burner, heat exchanger and seals, condensate, expansion vessel and system pressure, gas rate and operating pressure, combustion readings at high and low fire, flue and termination, ventilation, controls and safety devices, a carbon monoxide alarm, any unsafe situation, next service date and the engineer's registration. Scored on the checks. Not a landlord gas safety record. British spelling, UK practice.
Customer and Engineer
Whose boiler, where it is, and who serviced it.
Record title
Job or record number
Customer name
Property address
The property is — Owner-occupied home, Rented home, Social housing, Commercial premises, Other
Your business
Engineer
Engineer's Gas Safe licence number
Business Gas Safe registration number
Does the licence card show the categories for servicing this type of appliance? — Yes, No, N/A
Date of service
Date of the previous service, if known
The Boiler
What is being serviced, where, and how it is flued.
Boiler type — Combination boiler, System boiler, Regular (heat-only) boiler, Back boiler, Other
Where it is
Fuel — Natural gas, LPG
Flue type — Room-sealed, fan assisted, Room-sealed, natural draught, Open-flued, natural draught, Open-flued, fan assisted, Flueless, Not sure
Flue route — Horizontal through the wall, Vertical through the roof, Into a chimney or liner, Shared or communal flue, Other
Manufacturer and model
GC or serial number
Rated output (kW)
Year installed or approximate age
Anything the customer has noticed since the last service
Photo of the boiler and its data plate
Visual Check Before Opening Up
The boiler and what surrounds it, before any covers come off.
Is the boiler firmly fixed, with its case undamaged? — Yes, No, N/A
Is the case and surrounding area free of scorching, staining or soot? — Yes, No, N/A
Is there enough clearance round it to service it and for any air it needs? — Yes, No, N/A
Is the visible gas pipework sound, supported, and sleeved where it passes through walls? — Yes, No, N/A
Are the boiler and its connections free of water leaks? — Yes, No, N/A
Does the pressure relief discharge pipe end somewhere it cannot scald anyone? — Yes, No, N/A
Is the electrical supply through a suitable fused connection, secure and correctly rated? — Yes, No, N/A
Photographs — before work
Burner, Heat Exchanger and Seals
The boiler opened up, cleaned and inspected.
Was the burner cleaned and found in good condition? — Yes, No, N/A
Is the heat exchanger clear of debris, blockage and corrosion? — Yes, No, N/A
Are the ignition and sensing electrodes in good order and set to the maker's gap? — Yes, No, N/A
Is the combustion chamber insulation intact? — Yes, No, N/A
Do the fan and air sensing run cleanly, with clear tubes and connections? — Yes, No, N/A
Does it light first time, every time, on repeated starts? — Yes, No, N/A
Is the flame stable, evenly spread, and the colour the maker describes? — Yes, No, N/A
Are the case, door and burner seals intact, or renewed where they were not? — Yes, No, N/A
Seals or parts renewed
Photographs — inside the boiler
Condensate and Water Side
The condensate route, the expansion vessel and the system pressure.
Was the condensate trap cleaned and refilled? — Yes, No, N/A
Does the condensate pipe fall all the way, with any outside run insulated against frost? — Yes, No, N/A
Does it discharge to a suitable drain or soakaway? — Yes, No, N/A
Expansion vessel charge, measured with the system drained down (bar)
Is the expansion vessel charge at the maker's figure, or recharged to it? — Yes, No, N/A
System pressure cold (bar)
Is the system pressure within the maker's range and holding steady? — Yes, No, N/A
Where a system filter is fitted, was it cleaned? — Yes, No, N/A
Was the inhibitor level tested and found adequate? — Yes, No, N/A
Does hot water reach the taps at the expected temperature and flow? — Yes, No, N/A
Gas Rate and Pressure
The gas supply to the boiler, measured.
Standing pressure at the meter (mbar)
Operating pressure at the boiler inlet, at full rate (mbar)
Is the operating pressure within the manufacturer's range? — Yes, No, N/A
Gas rate
Is the gas rate within the manufacturer's range for this boiler? — Yes, No, N/A
Tightness test of the installation — Passed, Failed, Not carried out
Combustion Readings
The flue gas analyser readings, at high fire and at low fire where the maker asks for both.
Analyser calibration due by
High fire — CO (ppm)
High fire — CO2 (%)
High fire — CO/CO2 ratio
Low fire — CO (ppm)
Low fire — CO2 (%)
Low fire — CO/CO2 ratio
Are the combustion readings within the manufacturer's range for this appliance? — Yes, No, N/A
Photograph of the analyser printout or screen
Flue and Termination
The flue from the boiler to the open air.
Along its visible length, is the flue complete, jointed and supported correctly? — Yes, No, N/A
Where the flue passes through a void or boxing, could it be seen along its length? — Yes, No, N/A
Is the terminal clear of obstructions and far enough from windows, doors and other openings? — Yes, No, N/A
Is a terminal guard fitted where people could touch the terminal or it could be damaged? — Yes, No, N/A
Did the flue integrity check at the test point show no flue gases in the air intake? — Yes, No, N/A
Did the flue flow test show the flue drawing properly? — Yes, No, N/A
Did the spillage test pass, with doors closed and any extract fans in the same space running? — Yes, No, N/A
Photographs — flue and terminal
Ventilation
Air for combustion and for cooling, where this boiler needs it.
Is any ventilation this boiler needs present, correctly sized and unobstructed? — Yes, No, N/A
Are all vents clear, and has the customer been told to keep them that way? — Yes, No, N/A
Controls and Safety Devices
That the boiler is told what to do, and stops when it should.
Do the room thermostat and programmer switch the heating on and off? — Yes, No, N/A
Where there is a hot water cylinder, does its thermostat control the hot water? — Yes, No, N/A
Do the radiator valves and any zone valves operate? — Yes, No, N/A
Do the pump and diverter or zone valves work without noise or sticking? — Yes, No, N/A
Does the flame supervision device shut off the gas when the flame is lost? — Yes, No, N/A
Do the overheat and limit protections operate as the maker describes? — Yes, No, N/A
Where fitted, does frost protection work? — Yes, No, N/A
Is a working carbon monoxide alarm fitted in the room with the boiler, or close to it? — Yes, No, N/A
Was the customer shown how to use and reset the controls? — Yes, No, N/A
Unsafe Situations
Anything unsafe found on this visit, how it was classified, and what was recorded.
Classify and deal with any unsafe situation under the current Gas Industry Unsafe Situations Procedure. This section records what you found and did; it is not a substitute for the procedure.
Did you find an unsafe situation anywhere on the installation?
Classification — Immediately Dangerous (ID), At Risk (AR)
Which appliance or part of the installation
What you found, and what you did with the responsible person's agreement
Was a warning notice issued?
Warning notice number
The warning notice was — Signed by the responsible person, Refused — not signed, Left — responsible person not present
Photographs — the unsafe situation
Result and Sign-Off
How the boiler was left, when it is next due, and the signatures.
The boiler was left — Safe to use, Safe to use — advice given, Left off — unsafe situation recorded
Advice and recommended work
Work still to do
What needs doing
How soon — Before the boiler is used again, Within a week, Within a month, At the next service
Who is doing it
Due by
Next service due
Customer — name
Customer — signature
Engineer — signature
HVAC & Trades
Boiler Service Record
An engineer's record of the annual service of one boiler: appliance, fuel and flue type, a visual check of the installation, burner, heat exchanger and seals, condensate, expansion vessel and system pressure, gas rate and operating pressure, combustion readings at high and low fire, flue and termination, ventilation, controls and safety devices, a carbon monoxide alarm, any unsafe situation, next service date and the engineer's registration. Scored on the checks. Not a landlord gas safety record. British spelling, UK practice.
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Fitting and commissioning a new appliance rather than servicing one already in place? Use the installation record: Gas appliance installation check
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A boiler service record is the sheet an engineer completes at the yearly service of one boiler: what the appliance is and how it is flued, what was cleaned and inspected inside it, the water-side checks, the gas rate and pressure, the combustion readings, the state of the flue and ventilation, and whether the controls and safety devices did their job. This template follows the visit in the order you work and keeps every reading as a number. Fill it in here and download the PDF without an account, or speak while you walk, and the document writes itself.
What a service record shows
A service is more than a combustion reading. The boiler is opened, the burner, heat exchanger, electrodes and condensate trap are cleaned and inspected, seals are checked and renewed where needed, and the appliance is set up and proven against its maker's figures. The record is what proves all of that happened, and in what state the boiler was left.
Year on year it becomes the boiler's history: expansion vessel charge, system pressure and combustion figures that drift slowly are the early warning of a part on its way out. Many manufacturers also expect a dated record of each annual service before they will honour a warranty claim.
Readings, and the manufacturer's range
Operating pressure, gas rate, expansion vessel pressure, system pressure and the combustion figures — CO, CO2 and the ratio, at high and low fire where the maker asks for both — are typed in as numbers. Beside each group sits one question: is it within the manufacturer's range for this appliance?
The form deliberately states no limits of its own. The acceptable figures depend on the appliance, and the authoritative source is its installation and servicing instructions. A No on the combustion question is raised as a safety finding at the top of the report.
The flue type decides the tests
Choose the flue type in the appliance section. A room-sealed boiler shows the case seal and flue integrity checks; an open-flued one shows the flue flow and spillage tests, done with doors closed and any extract fans in the same space running. Flue, combustion and ventilation checks that fail become safety findings rather than ordinary repairs, because they are the ones that end in carbon monoxide.
Where a flue runs through a ceiling or boxed-in void, the form asks whether it could be seen along its length. A flue nobody can inspect is worth recording even when the boiler itself is in perfect order.
A service record is not a gas safety record
This is a service sheet for one boiler. It is not a landlord gas safety record (often still called a CP12), which is a separate annual safety check of every gas appliance and flue in a let home, with its own content set by the Gas Safety (Installation and Use) Regulations 1998. A service can be done at the same visit, and often is, but one document does not stand in for the other.
In Great Britain anyone servicing a gas boiler for payment must be on the Gas Safe Register, with the right categories on their card. The form records the engineer's licence number so the customer can check it.
Common questions
How often should a boiler be serviced?
Most manufacturers recommend once a year, and many make it a condition of the warranty. The form records the next service date so the reminder is on the customer's copy.
Is a boiler service the same as a gas safety check?
No. A service is maintenance of one appliance — cleaning, inspecting, setting up. A gas safety check, such as a landlord's annual check, confirms that every gas appliance and flue in the property is safe to use. The two are often done at one visit, but they are different jobs with different paperwork.
What combustion readings are acceptable?
The ones in the manufacturer's instructions for that appliance. This form records the figures you measured and asks whether they sit inside the maker's range, rather than printing a limit that may not apply to the boiler in front of you.
Why is the service record scored?
So that anything that did not pass stands out. Each failed check becomes a finding in the report, with flue, combustion and ventilation failures marked as safety findings, and the score shows at a glance how much of the service came back clean.
Can it be used for LPG boilers?
Yes. Choose LPG as the fuel. The checks and readings are the same; the operating pressure you compare against will be the one the maker gives for LPG.