Title Page

  • Address of subject property
  • Date of assessment

  • Name of Client

  • Email address for client

  • Telephone No.

  • Name of Domestic Energy Assessor

  • Council Tax Band

CWI and Loft Inspection

  • What is the property detachment

  • What is the property type

  • What its main heating source

  • Survey Type

EXTRACTION

  • Reason for Extraction

  • Additional Reason

  • Boroscope Evidence

  • Total Area to be Extracted

  • Has Client been advised on extent of Drilling and extraction points?

  • Are all potential ingress points been sealed internally?

  • Recommended cavity drying Time

  • If other please state

  • Material being Extracted

FOAM EXTRACTION

  • Cavity Vents, Underfloor Vents, Bedroom Vents & Combustion Vents

  • Have all vents been Identified?

  • Reason vents have not been identified

  • Have all Internal vents been Identified?

  • Please select rooms where vents to be sealed internally

  • Photo

  • Photo

  • Photo

  • Photo

  • Photo

  • Additional Room

  • Photo

  • Reason vents have not been identified

  • Has Main Heating appliance been Identified?

  • Has main heating have a Flue?

  • Is flue directed through an External wall?

  • Photo of Appliance

  • Photo of Flue

  • Position of Flue

  • Photo of Flue

  • Reason for Main Heating not being Identified

  • Have all windows throughout the property been checked for possible areas of ingress?

  • Please select rooms for possible areas of Ingress around Windows

  • Photo

  • Photo

  • Photo

  • Photo

  • Photo

  • Additional Rooms

  • Photo

  • Reason for checks not carried out?

  • Have all Internal leaf walls been checked for hairline cracks and defects?

  • Please select rooms where defects have been detected

  • Living Room Photo

  • Dining Room Photo

  • Kitchen Photo

  • Bathroom Photo

  • Bedroom Photo

  • Additional Rooms

  • Additional Photo

  • Reason checks have not been completed

  • Have all areas behind appliances on external walls been checks for possible areas of Ingress?

  • Photos behind appliances

  • Reasons for checks not completed

  • Are there any Built-In wardrobes on external walls?

  • Photo of Built-In wardrobes

  • Has the client been made aware of the requirement for technicians to complete internal checks and to seal up the property before extraction works can commence?

  • Has the client been made aware of the potential issues that may arise from extracting foam Insulation including the potential risk of dust ingress?

  • I have assessed the overall condition of the property ensuring its suitability for extraction. Whilst every possible precaution is taken to seal up prior to any extraction works commencing, it is not possible to ensure that dust and debris will not ingress into your property where previous trades have completed works on your property. Unless listed below, there are no additional significant hazards observed that are not addressed in the generic risk assessment for the works to be undertaken.

  • Additional

  • Assessors Signature

  • Clients Signature

CAVITY WALL

  • Total sqm to be Insulated

  • % of Property to be Installed

  • Required Material

  • If other please state

  • Average Cavity Width

  • Please state correct average Cavity width

  • Please select elevations to be installed

  • Front Boroscope Photo

  • Front DPC Photo

  • Cavity Depth Photo

  • Rear Boroscope Photo

  • Rear DPC Photo

  • Left Boroscope Photo

  • Left DPC Photo

  • Right Boroscope Photo

  • Right DPC Photo

  • Extension Boroscope Photo

  • Extension DPC Photo

  • Floor Type

  • State floor Type

  • Combustion vent Required?

  • Photo of Appliance requiring Combustion vent

  • Cavity Brush Required?

  • Number of Cavity Brushes Required

  • Adjoining properties insulated?

  • Reason Brushes not required

  • Location of Chimneys

  • Location of Flue

  • Additional Notes

  • Additional Photos

LOFT INSULATION

  • Scheme

  • State type of scheme

  • Total Area to be Insulated

  • Photo of Loft Hatch

  • Photo of Loft space

  • Existing Insulation

  • Existing Depth

  • Ofgem Loft Doc Required

  • Photo of Loft Doc Close up

  • Photo of Loft Doc in Situ

  • Photo of existing depth

  • Depth to be Added

  • Photo of Loft

  • Depth to be Installed

  • Down-lights present?

  • Select Rooms Down-Lights Present

  • Additional room

  • Total number of Down-Lights

  • Any water tanks need insulating?

  • Large Tank

  • Medium Tank

  • Small Tank

  • Photo of tanks

  • Any Pipework require Lagging?

  • Please state meters of pipework

  • High Amp electrical cables present? (e:g; Power Shower, Cooker)

  • Photo of appliance

  • Photo of Power Switch

  • Loft Hatch needing D/P

  • Relay Required?

  • Relay Sqm

  • Areas to be omitted

  • Total area to be omitted

  • Loft Vents required

  • Walkway required

  • Mtrs Required

  • Loft Clearance

  • Additional Notes

  • Additional Photos

Secondary Measures

  • Are we installing CWI and/or Loft Insulation?

  • Are we upgrading the heating controls/programmer to Smart Heating Controls?

  • Please provide images of the following.. Existing programmer and room thermostat, boiler, electricity meter and RCD unit

  • Are installing Radbots on the radiators?

  • Are the radiators in good condition?

  • Are any radiators in good condition?

  • Have you explained to the customer that will not eligible for RadBots? nb. if the rad are in poor condition then we cannot install new valves as they won't work correctly.

  • Which rooms are suitable for RadBots

  • Do the radiators have TRV's? (Thermostatic Radiator Valves)

  • Please provide imagery of each radiator and existing TRV's including pipework.

  • Can TRV's be fitted on the radiators?

  • What is the size of the pipework?

  • Please provide imagery of each radiator and the valves, include the pipework.

  • When was the boiler last serviced?

  • Do all radiators heat up properly

  • Which radiators don't heat up properly?

  • Have you explained that we will not be able to install RadBots on under performing radiators?

Easy Measures

  • Are we installing CWI and/or Loft Insulation?

  • Do the windows and door require draught proofing?

  • Please provide images of doors/windows that require DP

  • Do the radiators require reflective panels?

  • What is the size of each radiator?

  • Please provide images of each radiator and a tape measure showing the gap from behind the rad to the wall.

  • Are there any open fireplaces/chimneys in the property

  • Are the fire places in use?

  • Can we install a chimney balloon?

  • Please provide imagery of the chimney/fireplace inc. the inside of the chimney flue if possible

  • Are all the lightbulbs low energy?

  • How many are not low energy

  • Can we replace the light bulbs with low energy lightbulbs?

  • How many light bulbs require an upgrade?

  • Please provide images of each light bulb in need of an upgrade.

Ventilation

  • Are we installing CWI and/or Loft Insulation?

  • Have ALL wet rooms got extraction fans? (Kitchen, Bathroom, Utility and En-Suites)

  • Please provide images of each extraction fan.

  • What rooms do not have extractor fans?

  • Do any wet rooms have extractor fans?

  • Which wet rooms have extractor fans?

  • Please provide images of existing extractor fans

  • Is there any condensation issue in any of the rooms throughout the property?

  • What rooms have condensation issues?

  • Have the rooms got trickle ventilation?

  • Do you know of the route cause of the condensation?

  • Please explain the cause of condensation and the mitigation plan.

  • Can we install trickle ventilation in the windows?

  • What rooms require trickle ventialtion?

  • Please provide images of windows that require trickle ventilation

  • Can we install background ventilation?

  • What rooms require background ventilation?

  • Please provide image of the rooms that require background ventilation.

  • Can we mitigate against the condensation?

  • What is the mitigation of the risk?

Risk Assessment

  • Undertake Risk Assessment

  • Type of Works

  • Cavity Wall Insulation Risk Assessment Questions

  • Overhead Electricity Cables Present?

  • Does the Property have a Garage?

  • Does the Property have a Porch?

  • Does the Property have an Outside Tap?

  • Does the Property have Finlock Gutters?

  • Does the Property suggest that Asbestos could be Present?

  • Confirm you have asked the Client if there was any known Asbestos or Asbestos containing materials within the property

  • Do you or the Client have any Reason to suspect Asbestos is present in the Property?

  • Access from Road/ Around Property

  • Is there any Evidence of Vermin?

  • Is there any Evidence of Protected Wildlife? (e.g. Bats)

  • Use of a Mobile Tower Required?

  • Working on Roof Required?

  • Vibration Likely?

  • High Noise Levels Likely?

  • Working with Wet Cement/ Concrete/ Mortar required?

  • Use of Mobile Elevation Working Platform (MEWP) required?

  • If Obstructions present, can an extended Lance be used to Remedy?

  • Reversing of Vehicle Required?

  • Electricity Required?

  • Housekeeping Required

  • Distance from Works vehicle to Property

  • Will Public Walkway be at Risk?

  • Is neighbour access required?

  • Safety Signage required?

  • Loft Insulation Risk Assessment Questions

  • Does the Property suggest that Asbestos could be Present?

  • Confirm you have asked the Client if there was any known Asbestos or Asbestos containing materials within the property

  • Do you or the Client have any Reason to suspect Asbestos is present in the Property?

  • Have all checks been Undertaken to determine if Asbestos containing materials are present within the property?

  • Access from Road/ Around Property

  • Is there any Evidence of Vermin?

  • Is there any Evidence of Protected Wildlife? (e.g. Bats)

  • Vulnerable Person Present?

  • Use of Ladders Required?

  • Manual Handling Required?

  • Reversing of Vehicle Required?

  • Electricity Required?

  • Housekeeping Required

  • Distance from Works vehicle to Property

  • Will Public Walkway be at Risk?

  • Is neighbour access required?

  • Safety Signage required?

  • Electricity Cables present in Loft

  • Working in Confined Spaces required?

  • Lone Working?

  • Use of Scaffold required?

Overview

  • What measures are we installing at this property?

  • Have you completed an EPC

  • What is the EPC Rating?

  • What is the rating after measures have been installed?

  • Why have you not completed EPC? Note:this is a requirement of the funding and we cannot continue without.

  • Does the client receive any benefits?

  • What benefit does the client receive

  • Has the customer opted out of any additional ventilation at the property? (if required)

  • As the owner of the property I have decided to opt out of having any additional ventilation added to my property. I can confirm that the requirement and the benefit of additional ventilation has been explained to me by the assessor. However, I can confirm that I have declined to proceed with the proposed ventilation strategy.

  • If applicable, what is the m2 of CWI?

  • If applicable, what is the m2 and mm of the Loft Top Up?

  • If applicable, how many Smart Controls are we fitting?

  • If applicable, how many RadBots 2R's are we fitting?

  • If applicable, how many dMEV's are we fitting?

  • If applicable, how many Trickle Vents are we fitting?

  • Has the customer agreed to proceed with having the aforementioned work installed.

  • Clients signature

  • Assessor name

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