something like this,
Engineer……………………………………………Company……………………………………………
Date:-………………………………………………..Ref………………………………………………….
Address:-……………………………………………………………………………………………………
………………………………………………………………………………………………………….……
…………………………………………………………………………………………………………….…
Name of householder / property owner:-………………………………Tel:-……………………..……
Why does system need flushing?
Recommendation by other company Previous survey New boiler installation
British Gas / other?
Problems identified:
Type of system:-
Vented Sealed Fully pumped Gravity hot water Thermal store
(Cap off cold feed and expansion pipes.) (Non return valve on radiator circuit?) Can gravity circuit be closed off? Need valve to be fitted? (Drain down and loop out cylinder, and flush radiator and boiler circuits separately.)
Age of system:-
Boiler Radiators Pipework
Type of boiler and make / model:-
Conventional Combi type Condensing
Serial number: If condensing boiler, is secondary heat exchanger aluminium?
Location of boiler:-……………………………………………………………………………
Type of water cylinder:-
None (combi system) Conventional indirect Primatic / Fortic Thermal store
(Loop out cylinder.) (Loop out cylinder, and flush radiator & boiler circuits separately.)
Type of pipework:-
Copper 15mm/22mm Microbore Single pipe Steel pipe work?
If microbore system, are twin entry radiator valves fitted? Are all radiators completely warm when boiler fired? (i.e. are the radiator ‘injector’ tubes still fitted correctly?)
If single pipe system, is there circulation (heat) to all radiators? Cold radiators will need removal from system and individual flushing.
If elderly steel pipe work, is system sufficiently sound to power flush? (Or would it be better to re-pipe?)
Location of system circulator pump:-
In boiler casing Adjacent to boiler In airing cupboard Elsewhere?
Number of radiators?:-
Steel Aluminium Are they all getting warm? TRVs fitted? Any obvious signs of neglect / leaks?
Yes / No
Do all thermostatic radiator valves (TRVs) open fully?
Are there zone valves? Where are they located?
Number of valves Airing cupboard Elsewhere
F & e tank
Location Checked ? Condition?
Best place to connect onto for good fresh water supply?:-……………………………………...
Best place to locate Clearflow pump?:-……………………………………………………
Across circulator pump fittings On circulator pump body, using CPII adaptor Across radiator tails Across flow and return at boiler Across flow and return pipe work from disconnected cylinder
Need to use a drip tray?…………………………………………………….
Best place to run dump hose to?:-……………………………………………………………….
Toilet Outside drain External hopper Elsewhere?
CLEARFLOW® power flush monitoring form
Visual inspection of system water before powerflush:
Clear Orange Dark brown Black
Analysis results
Test parameter Mains water System water before power flush System water after power flush
pH
Soluble iron (ppm)
Soluble copper (ppm)
Chloride (ppm)
Hardness
Inhibitor (ppm molybdate)
TDS (Total Dissolved Solids) readings
Mains water (ppm) System water before flush (ppm)
When checking dump water TDS from each radiator when dumping, note results below (ppm):
Radiator 1 Radiator 8 Radiator 15
Radiator 2 Radiator 9 Radiator 15
Radiator 3 Radiator 10 Radiator 17
Radiator 4 Radiator 11 Radiator 18
Radiator 5 Radiator 12 Radiator 19
Radiator 6 Radiator 13 Radiator 20
Radiator 7 Radiator 14 Radiator 21
Flushing chemical used:
Power Flush FX2 Hyper Flush
Corrosion inhibitor used:
Systemsafe-DM Systemsafe-IC
The undersigned has power flushed the system according to best industry practice and following procedures detailed in code of practice BS7593:2006.
Name: Signature:
Date: