Quality inspection checklists · Healthcare services quality checklists · used by 2 trades
KD-QA-MG-001
Medical Gases — Pipework, Pressure, Purity and AP Witness (HTM 02-01) — Quality Inspection Checklist
Medical gas pipeline systems from installation to the Authorised Person's acceptance · degreased copper brazed under inert gas, tests before concealment witnessed by the AP, terminal units proved, purity by the Quality Controller, nothing used before the AP signs.
4 pages · 215 fillable fields · works in Adobe Reader, Preview, Chrome, or on a phone — or complete it online in your browser and download the finished document.
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Read all 4 pages first — watermarked sample, no email Before you submit: the checklist
Statutory basis, cited on the form
- IRR 2017 — Ionising Radiations Regulations 2017
- Part 3:2019 test methods)
Guidance and standards relied on
These are not law. HSE guidance carries no statutory force in itself, British Standards and NASC technical guidance are industry documents, and the Joint Code of Practice is an insurers' code. They are what the document is built to — and where a court would look for the standard of the reasonable contractor.
- HTM 02-01 (2006) — medical gas pipeline systems, Parts A and B
- HTM 03-01 (2021) — specialised ventilation for healthcare premises, Parts A and B
- HTM 08-03 (2013) — bedhead services
- HTM 04-01 (2016) — safe water in healthcare premises
- BS EN ISO 14644 (cleanrooms and associated controlled environments — Part 1:2015 classification
- BS 1710:2014 (identification of pipelines and services)
- BS 7671:2018+A4:2026 (IET Wiring Regulations, 18th edition, Amendment 4)
What it is not
It is not a completed document and it is not health and safety advice. You must adapt it to your site and have a competent person complete and sign it off. See why we don't say "compliant".
Format
AcroForm fillable PDF. Every field has a tooltip. Tab order follows the reading order. Works on desktop and mobile, in Adobe and non-Adobe readers.
This revision was prepared against legislation current at 10 August 2026. Revision A0. Check kubitdocs.com/revisions for the current revision before use.
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This document is used by 2 trades: Mechanical, Plumbing & HVAC, Medical Gas Pipeline Systems.