A description of and the location of each appliance or flue checked.
The name, registration number and signature of the individual carrying out the check
The date on which the appliance or flue was checked
The address of the property at which the appliance or flue is installed
The name and address of the landlord (or his agent where appropriate)
Any defect identified and any remedial action taken
A statement confirming that the safety check completed complies with the requirements of the Gas Safety (Installation and Use) Regulations 1998