CDVCCDVCCOSafetySurvey

Supporting Voluntary Action in the Canterbury Distirct

Suppporting Voluntary Action
in the Canterbury District

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Name

First

Last

information of Carbon

Telephone number

Age

Type of home

Tenure

Main Heating

Household Appliances

Do have any Carbon Monoxide Alarms?

How often do you test your Carbon Monixide Alarms? (copy)

Do you know any of these symptoms of Carbon Monoxide Poisoning?

Do you recognise any of these signs of Carbon Monoxide issues?

Do you:

Get coal, oil and natural gas appliances checked annually by a qualified professional?
Ensure there is adequate ventilation for appliances and don't block air vents?
Ever bring a BBQ or portable heater into and enclosed spac e without proper ventilation?
Turn off appliances and seek immediate assistance if you suspect Carbon Monoxide or your CO alarm sounds?

Would you follow these 6 steps if you smelt gas?

Open windows and doors to help ventilate the gas.
Turn off the gas supply at the meter and make sure any gas appliances are turned off.
Call the Natiaonl Gas Emergency number on 0800 111 999.
Do not smoke or use any naked flames
Don't touch any electrical switches as this could ignite a gas leak.
Don't enter a cella if you smell gas, event if your gas meter is located in teh cellar.

Would you like us to contact you in regard to Carbon Monoxide support?

We have a limited supply of free CO alarms, would you like us to provide one for you if we still have these available?

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