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Landlord gas safety record template
A landlord gas safety site record for Gas Safe registered engineers. Record the property, landlord and engineer, then each appliance and flue with its checks, combustion reading, whether it is safe to use and any defect and remedial action. The installation section covers the tightness test, emergency control valve, bonding and carbon monoxide alarms. Every question is listed below, and you can fill the live form in on this page.
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What must a landlord gas safety record include?
Regulation 36 of the Gas Safety (Installation and Use) Regulations 1998 says the record must include the date of the check, the property address, the landlord's or agent's name and address, a description and location of each appliance or flue, any safety defect, any remedial action, confirmation that the check met the regulations, the engineer's name and signature, and their Gas Safe registration number.
Last updated . Facts checked by the SiteSurvey team on 17 October 2026 against regulation 36 of the Gas Safety (Installation and Use) Regulations 1998, HSE: gas safety check records and what to keep, HSE: gas safety checks, who can do them, HSE: domestic gas FAQs (Gas Industry Unsafe Situations Procedure) and GOV.UK: Smoke and Carbon Monoxide Alarm (Amendment) Regulations 2022, guidance for landlords and tenants.
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Every question in the landlord gas safety record template
A landlord gas safety site record: every appliance and flue room by room with its checks, analyser readings against the manufacturer's limit, defects and remedial action, counts of unsafe appliances, the installation checks, the engineer's Gas Safe number and the details regulation 36 requires. 3 sections and 62 questions. Follow-up questions and guidance appear only when an answer calls for them, so the person on site never sees the ones that do not apply.
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This is a starting point, not a fixed form. Once it is in your SiteSurvey account you can reword any question, add or remove questions, sections and answer options, and add your own logo, so it fits the way your team works and the jobs you do.
Details you only enter once
Add this form to a project in SiteSurvey and it fills in what the project already knows, so nobody on site retypes it and every form on the job uses the same names. Anything filled in can still be changed.
- Project: the project name
- Client: the project's customer
- Site: the site, when the form is opened for a space or a product
- Site address: the site address, from the space or the project
Property and engineer
- ProjectShort answerFills in from the project name
- ClientShort answerFills in from the project's customer
- Site*Short answerFills in from the site, when the form is opened for a space or a product
- Site address*Short answerFills in from the site address, from the space or the project
- Property locationShort answer
Mark it at the front door, or by the meter if it is outside. Tap Mark current location on site. It saves the coordinates, a grid reference and the accuracy.
- Date of the check*Date
- TimeTime
- Date of the previous gas safety checkDate
From the last record, if there is one.
- Days since the previous checkWorked out by the formShown only when the answers above make it relevant
- CheckMore than 12 months since the previous check. Regulation 36(3) requires checks at intervals of not more than 12 months, and no check may be made late. Under regulation 36A a check made in the 2 months before its deadline is treated as made on the deadline date, so the gap can be up to about 14 months. Enter the deadline from the previous record below to check it.Shown only when the answers above make it relevant
- Deadline for this check (next due date on the previous record)Date
Optional. Under regulation 36A this can be later than 12 months after the previous check.
- WarningThis check is after the deadline on the previous record. Regulation 36 does not allow a late check. Record why it was late and make sure every appliance is now in date.Shown only when the answers above make it relevant
- Landlord or agent, name and address*Short answer
- TenantShort answer
- Engineer name*Short answer
- Gas Safe registration number (business)*Short answer
- Engineer licence numberShort answer
- GuidanceGas Safety (Installation and Use) Regulations 1998, regulation 36. Landlords must have each appliance and flue checked for safety within 12 months of installation and then at least every 12 months, by a Gas Safe registered engineer. Give a copy of the record to existing tenants within 28 days of the check, and to new tenants before they move in. Keep it until two further checks have been made.
- CheckThis form records the information regulation 36 requires. Many engineers issue the formal record from their own certification software.
Appliances and flues
- RoomsRepeat for each entry. Each one asks:
- Room*Short answer
- Gas appliances in this roomRepeat for each appliance. Each one asks:
- Type*Choose one
- Boiler
- Gas fire
- Cooker or hob
- Water heater
- Warm air heater
- Other
- Make and modelShort answer
- Scan the data plateScan a label: serial number, model number
Optional. Scan the label or tag to capture its numbers.
- Owned by the landlord?Yes or No
- Flue typeChoose one
- Room sealed
- Open flue
- Flueless
- Balanced flue
- Operating pressure or heat inputShort answer
Or the combustion performance, where it is not reasonably practicable to examine these.
- Safety devices operate correctlyChoose one
- Pass
- Fail
- Not applicable
- Ventilation satisfactoryChoose one
- Yes
- No
- Not applicable
- Flue visual condition satisfactoryChoose one
- Yes
- No
- Not applicable
- Flue performance test (spillage or flue flow)Choose one
- Pass
- Fail
- Not applicable
- CO reading (ppm)Number
As shown by the combustion analyser.
Shown only when the answers above make it relevant - CO/CO₂ ratioNumberShown only when the answers above make it relevant
- Highest ratio allowed by the manufacturer's instructionsNumber
Enter the figure from the appliance's instructions. The form does not hold any limits of its own.
Shown only when the answers above make it relevant - Ratio against the manufacturer's limitWorked out by the formShown only when the answers above make it relevant
- CheckThe ratio is above the limit in the manufacturer's instructions. Follow those instructions and the unsafe situations procedure before the appliance is left in use.Shown only when the answers above make it relevant
- Above the limit (1 = yes)Worked out by the form
- Other analyser readings or notesShort answer
For example the flue gas temperature, O₂ or CO₂, or why a reading was not taken.
- Appliance serviced?Yes or No
- Safe to use?Yes or No
- Unsafe situationChoose one
- At risk
- Immediately dangerous
Shown when “Safe to use?” is No - WarningUnsafe appliance. Follow the Gas Industry Unsafe Situations Procedure, tell the responsible person, and record the warning label or notice issued.Shown when “Safe to use?” is No
- Safety defect identifiedNotesShown when “Safe to use?” is No
- Remedial action takenNotesShown when “Safe to use?” is No
- PhotosPhotos
- This room: appliances checkedWorked out by the form
- This room: appliances not safe to useWorked out by the form
- This room: immediately dangerousWorked out by the form
- This room: at riskWorked out by the form
- This room: ratio above the limitWorked out by the form
- This room: landlord's appliancesWorked out by the form
- RoomsWorked out by the form
- Appliances checkedWorked out by the form
- Landlord's appliancesWorked out by the form
- Appliances not safe to useWorked out by the form
- Immediately dangerousWorked out by the form
- At riskWorked out by the form
- Ratio above the manufacturer's limitWorked out by the form
- WarningAn appliance is immediately dangerous. It must not be left connected or in use. Follow the Gas Industry Unsafe Situations Procedure and record the warning notice and who was told.Shown only when the answers above make it relevant
Installation
- Gas tightness testChoose one
- Pass
- Fail
- Not done
- Emergency control valve accessible?Yes or No
- Protective equipotential bonding present?Yes or No
- Carbon monoxide alarm fitted in each room with a fixed combustion appliance (other than a gas cooker), and tested?Yes or No
- CheckIn England, the Smoke and Carbon Monoxide Alarm (England) Regulations 2015 (as amended in 2022) require landlords to fit a carbon monoxide alarm in any room used as living accommodation that has a fixed combustion appliance, other than a gas cooker.Shown when “Carbon monoxide alarm fitted in each room with a fixed combustion appliance (other than a gas cooker), and tested?” is No
- I confirm the check meets regulation 36(9) of the Gas Safety (Installation and Use) Regulations 1998*Yes or No
- Next check due byDate
Normally within 12 months of this check. If this check was done up to 2 months early under regulation 36A, the next is due 12 months from the original deadline.
- Days from this check to the next due dateWorked out by the formShown only when the answers above make it relevant
- CheckThe next due date is more than 12 months after this check. That is only right where this check was done in the 2 months before the previous deadline and the deadline date is kept (regulation 36A). Otherwise check the date.Shown only when the answers above make it relevant
- Engineer name*Short answer
- Engineer signatureSignature
- Received by (landlord, agent or tenant)Short answer
- SignatureSignature
See it filled in
A completed landlord gas safety record report, made by SiteSurvey from a fictional site visit: every answer, the photos, the guidance that applied and the sign-off, ready to send as a PDF.
Landlord gas safety record FAQs
How often do landlords need a gas safety check?
Each gas appliance and flue must be checked within 12 months of being installed and then at intervals of no more than 12 months. For a new tenancy, the check must have been done within the 12 months before it starts. A check done up to 2 months early can keep the original deadline date (regulation 36A). Only a Gas Safe registered engineer can do the check.
When must tenants get a copy?
Give a copy to each existing tenant within 28 days of the check, and to a new tenant before they move in. For lets of 28 days or less, the record can instead be displayed prominently in the property.
How long must the record be kept?
Until there have been two further checks of the appliance or flue, or for 2 years after the last check if the appliance has been removed.
Is this the same as a CP12?
HSE calls it the landlord gas safety record, previously referred to as a gas safety record, certificate or CP12 form. Gas Safe Register does not produce its own form. This form captures every item regulation 36 requires. Many engineers issue the formal record from their own certification software; this is the site record behind it.
What happens if an appliance is unsafe?
Answer that it is not safe to use and the form asks whether it is at risk or immediately dangerous, the categories in the Gas Industry Unsafe Situations Procedure, then the defect and the remedial action, and reminds you to record the warning label or notice issued. Both categories carry a 'Danger Do Not Use' label.
Does it check carbon monoxide alarms?
Yes. In England, private and social landlords must fit a carbon monoxide alarm in any room used as living accommodation that contains a fixed combustion appliance, other than a gas cooker. The form asks whether one is fitted and tested.
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Templates that go with the landlord gas safety record form
A commercial kitchen gas safety site record: each appliance checked, gas tightness, ventilation and the gas interlock, flues and flame supervision, emergency isolation, unsafe situations and the engineer's sign-off.
A gas boiler service record with appliance identity, engineer scope, manufacturer checks, measured results, defects, remedial work and customer handover.
Periodic tenancy inspection: tenant's account, alarms and safety records, room by room condition, repairs with priorities.
A void property inspection: keys, meter readings, gas and electrical safety dates, smoke and CO alarms, damp and mould, room-by-room condition and the works list to bring the home up to the lettable standard.
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