Report of a Dangerous Gas Fitting

About you and your organisation

*Title

*Forename

*Family Name

*Job Title

*Your Phone No

*Organisation Name

*Address Line 1

Address Line 2

Address Line 3

*Town

County

*Post Code

Fax Number

*E-Mail

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About the incident

*When was the dangerous gas fitting found?

*Where was the dangerous gas fitting found?

*Address Line 1

Address Line 2

Address Line 3

*Town

County

*Post Code

In which local authority is the address where the dangerous gas fitting was found?

Please indicate the local authority area in which the site is located. You need to select the Country first, then the geographical area (England only), and finally the local authority.
Selecting the local authority will help ensure that the appropriate Enforcing Authority (EA) for that area receives the notification.
For local authorities in England, each is allocated to a geographical area. The information is available on gov.uk 'Find your local council'

*Country

*Geographical Area

*Local Authority

*Was it in a building?

Yes No

If yes, what type of building?

And in what room?

*Was the fault repaired at the time?

Yes No

*If not, were the premises made safe by disconnection or contact made with National Grid's emergency centre for them to disconnect?

Yes No

*Were the premises rented?

Yes No

What is the name of the person living in the premises?

*Title

*Forename

*Family Name

Details of the landlord or their managing agent

*Title

*Forename

*Family Name

Phone No

*Address Line 1

Address Line 2

Address Line 3

*Town

County

*Post Code

*Was the landlord or their managing agent notified about the faults?

Yes No

About the dangerous appliance or gas fitting

*What was the main fault found with the appliance or gas fitting?

*Was an appliance or other type of gas fitting involved?

Appliance Gas Fitting

*What type of appliance or gas fitting was involved?

*What type of gas was involved?

*What was the design/construction type of the appliance?

Was the appliance bought second hand?

Yes No Not known

*Summary of the dangerous gas fitting. (HSE does not require any personal data to entered into this text box. Please consider what data you are inputting and ensure it does not contain any personal data before you submit the form).

Please provide further relevant information

About the servicing and installation of the appliance

I know details about the last service I know details about the installer I do not know any details about the last service or the installer

Last service details

Who last serviced the appliance?

*Title

*Forename

*Family Name

Phone No

*Address Line 1

Address Line 2

Address Line 3

*Town

County

*Post Code

Installer details

*On what date was the appliance installed?

Name and address of the installer

*Title

*Forename

*Family Name

Phone No

*Address Line 1

Address Line 2

Address Line 3

*Town

County

*Post Code

Thank you for submitting your RIDDOR form

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