LPG Distributor Inspection Report
EC Act LPG Order 2000 Safety Integrated
01
Basic Details of Distributor
Distributor Name
Proprietor / Manager
Address
Block Name
Oil Marketing Company
Distributor Code
Agreement No.
Date & Time of Inspection
02
Stock Verification of LPG Cylinders
Physical Count
A — Filled Cylinders
TypeOpeningReceiptTotalIssueBalancePhysicalDifference
14.2 Kg Domestic
19 Kg Commercial
5 Kg Domestic
B — Empty Cylinders
TypeOpeningReceiptTotalIssueBalancePhysicalDifference
14.2 Kg Domestic
19 Kg Commercial
5 Kg Domestic
C — Other Cylinders (Defective / Seized)
Type14.2 Kg5 Kg (D)19 Kg5 Kg (C)
Defective / Damaged
Seized / Zima
03
Consumer Database Verification
04
Refill Cylinder Supply — Last 3 Months, Category Wise
MonthDomestic Cylinders ReceivedCommercial Cylinders Received
14.2 Kg5 Kg19 KgOther
Month 1
Month 2
Month 3
05
Safety & Certificate Compliance
Fire + Legal Metrology
🔥 Fire Safety Certificate & Inspection
Fire Safety Cert. No.
Valid Up To
Last Inspection Date
Fire NOC Reference
⚖️ Legal Metrology — Weights & Measures
Weighing Scale (Model/ID)
Certified Test Weight Set
Spring Balance (Yes/No)
Scale Verification Due Date
LMPC Certificate Available
06
Valve / O-Ring & Leakage Verification
07
Delivery & Distribution System
08
Additional Safety Checks at Godown
09
Records Verified
!
LPG-Specific Safety Status
No Smoking / No Mobile signage displayed
Fire extinguisher monthly check up to date
Hydrostatic test record verified
Valve protection caps intact
Flameproof fittings compliant
Leak detection checklist maintained
Inspecting Officer — Name & Designation
Signature
Date of Inspection
Official Stamp
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