Gas Boiler System Commissioning Checklist Form
Document all required checks and outcomes for gas boiler system commissioning and startup. Use this form for official commissioning records.
Commissioning Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Site / Location
*
Installer / Technician Name
*
First Name
Last Name
Boiler / System Identification (Model, Serial Number, etc.)
*
Pre-Commissioning Checks Completed
*
Pipework pressure tested and leak-free
Electrical connections secure
System flushed and filled
Ventilation checked and clear
Combustion and Safety Checks Completed
*
Gas soundness test passed
Flue integrity verified
Safety devices tested
Functional Test Results
*
Boiler ignites correctly
Heating circuit operational
Hot water circuit operational
Defects or Issues Found
Corrective Actions Required
Commissioning Completion Status
*
Passed – System commissioned successfully
Failed – Further action required
Submit Checklist
Should be Empty: