CURCLEBY HERRIDGE

Landlord Gas Safety Record

Record No. ______________
Date of inspection ______________

Property & responsible person

Property address

Postcode

Landlord / agent name

Landlord / agent address

Number of appliances tested

Number of appliances not tested

Appliance details

Location	Appliance type	Make & model	Flue type	Operating pressure / heat input	Safety devices correct?	Combustion (CO/CO₂)	Appliance safe to use?

Inspection results

Appliance / installation	Flue check	Visual inspection	Defects identified	Remedial action / advice

Engineer & next inspection

Gas engineer name

Gas Safe registration no.

Company

Next inspection due (within 12 months)

Engineer signature

Received by (landlord / tenant)

Free template provided by Curcle by Herridge field service software. This is a general-purpose starting point and is not a substitute for an official record or professional advice. Gas work must only be carried out by a Gas Safe registered engineer, and records must comply with the Gas Safety (Installation and Use) Regulations 1998 and current guidance. Verify all content meets your legal obligations before use.