Before you use this sheet

This is a free record template from TradieRoles, provided by FTC Group Pty Ltd. It records a gas soundness test, it does not perform or certify it.

Only a licensed / authorised gasfitter may test and commission gas installations.
Test pressures, let-by and permitted pressure drop must follow AS/NZS 5601.1 (AU) or NZS 5261 (NZ) and the appliance data.
FTC Group accepts no liability for the completed record.

I understand this is a record template and I am responsible for compliance.

GasIQ

Gas Soundness Sheet

Leakage test & appliance commissioning · AS/NZS 5601.1

Leakage test & appliance commissioning · NZS 5261 / AS/NZS 5601

AU · AS/NZS 5601

Project / Site

Client

Site address

Gas type

Meter / regulator

Installation description

Gasfitter / Company

Gas work authorisation no.

Date

Gasfitter reg. / PGDB no.

AS/NZS 5601.1 soundness test. Record the pressure test and the let-by test. The installation must show no perceptible pressure drop over the required test period at the specified test pressure before appliances are connected and commissioned.

NZS 5261 soundness test. Record the pressure test and the let-by test. The installation must hold the specified test pressure with no permitted drop over the test period before appliances are connected and commissioned.

1Soundness (leakage) test

Test medium

Operating pressure (kPa)

Test pressure (kPa)

Let-by test result

Start time

Start pressure (kPa)

End time

End pressure (kPa)

Hold duration

Pressure drop (kPa)

Permitted drop

Result

2Purge

Purge method

Pipe volume (m³)

Gas detected at outlet

Result

3Appliance commissioning

Appliance	Gas rate (MJ/h)	Burner pressure (kPa)	Combustion / CO (ppm)	Flue / ventilation	Result

4Declaration

Notes / defects

I certify the gas installation described was tested and commissioned in accordance with AS/NZS 5601.1 and the results above are a true record. A Certificate of Compliance is to be issued as required by the relevant State or Territory gas regulator.

I certify the gas installation described was tested and commissioned in accordance with NZS 5261 and the results above are a true record. A gas Certification / Certificate of Compliance is to be issued and supplied as required under the Gas (Safety and Measurement) Regulations.

Tested by

Signature

Authorisation no.Registration no.

Date

Free record template · TradieRoles Tools · © FTC Group Pty Ltd (ABN 70 694 989 994). Provided as-is with no warranty. Testing, commissioning and certification remain the responsibility of the licensed / authorised gasfitter. Verify against the current edition of AS/NZS 5601.1 (AU) or NZS 5261 (NZ).

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