Agility A-D Property Assessment

• Address of subject property
  Address

• Date of assessment

  Date

• Name of Client

• Email address for client

• Telephone No.

• Name of Domestic Energy Assessor

  Select Luke Finnemore Sean Swann Lewis Trigg Stephen Summers Justin Jones Andrew Martel James Abercrombie Joseph Davies Jason Pace Andrew Simpson Mitchell Randle

  • Luke Finnemore
  • Sean Swann
  • Lewis Trigg
  • Stephen Summers
  • Justin Jones
  • Andrew Martel
  • James Abercrombie
  • Joseph Davies
  • Jason Pace
  • Andrew Simpson
  • Mitchell Randle

• Council Tax Band

• What is the property detachment

  Semi Detached

  End of Terrace

  Mid Terrace

  Detached

• What is the property type

  House

  Flat

  Bungalow

• What its main heating source

  Select Gas Boiler Electric Storage Heaters Electric Room Heaters Air Source Heat Pump Solid Fossil Fuel Boiler Solid or gas fireplaces Other - type in notes

  • Gas Boiler
  • Electric Storage Heaters
  • Electric Room Heaters
  • Air Source Heat Pump
  • Solid Fossil Fuel Boiler
  • Solid or gas fireplaces
  • Other - type in notes

• Survey Type

  Select Cavity Loft Extraction

  • Cavity
  • Loft
  • Extraction

EXTRACTION

• Reason for Extraction

  Select Low Density fill resulting in voids creating cold spots Building debris evidenced Building defects resulting in contaminated insulation Water penetration Other

  • Low Density fill resulting in voids creating cold spots
  • Building debris evidenced
  • Building defects resulting in contaminated insulation
  • Water penetration
  • Other

• Additional Reason

• Boroscope Evidence

  Media

• Total Area to be Extracted

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

  Yes

  No

  N/A

• Are all potential ingress points been sealed internally?

  Yes

  No

  N/A

• Recommended cavity drying Time

  1 Week

  2 Weeks

  N/A

  Other

• If other please state

• Material being Extracted

  Select White Fibre Yellow Fibre Rockwool Bead Foam Building Debris

  • White Fibre
  • Yellow Fibre
  • Rockwool
  • Bead
  • Foam
  • Building Debris

FOAM EXTRACTION

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

• Have all vents been Identified?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Reason vents have not been identified

• Have all Internal vents been Identified?

  Yes

  No

  N/A

• Please select rooms where vents to be sealed internally

  Select Living Room Dining Room Kitchen Bathroom Bedrooms Other

  • Living Room
  • Dining Room
  • Kitchen
  • Bathroom
  • Bedrooms
  • Other

• Photo

  Media

• Photo

  Media

• Photo

  Media

• Photo

  Media

• Photo

  Media

• Additional Room

• Photo

  Media

• Reason vents have not been identified

• Has Main Heating appliance been Identified?

  Yes

  No

  N/A

• Has main heating have a Flue?

  Yes

  No

• Is flue directed through an External wall?

  Yes

  No

• Photo of Appliance

  Media

• Photo of Flue

  Media

• Position of Flue

• Photo of Flue

  Media

• Reason for Main Heating not being Identified

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

  Yes

  No

  N/A

• Please select rooms for possible areas of Ingress around Windows

  Select Living Room Dining Room Kitchen Bathroom Bedrooms Other

  • Living Room
  • Dining Room
  • Kitchen
  • Bathroom
  • Bedrooms
  • Other

• Photo

  Media

• Photo

  Media

• Photo

  Media

• Photo

  Media

• Photo

  Media

• Additional Rooms

• Photo

  Media

• Reason for checks not carried out?

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

  Yes

  No

  N/A

• Please select rooms where defects have been detected

  Select Living Room Dining Room Kitchen Bathroom Bedrooms Other

  • Living Room
  • Dining Room
  • Kitchen
  • Bathroom
  • Bedrooms
  • Other

• Living Room Photo

  Media

• Dining Room Photo

  Media

• Kitchen Photo

  Media

• Bathroom Photo

  Media

• Bedroom Photo

  Media

• Additional Rooms

• Additional Photo

  Media

• Reason checks have not been completed

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

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photos behind appliances

  Media

• Reasons for checks not completed

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

  Yes

  No

• Photo of Built-In wardrobes

  Media

• 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?

  Yes

  No

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

  Yes

  No

• 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.

  None

  See Below

• Additional

• Assessors Signature

  Sign

• Clients Signature

  Sign

CAVITY WALL

• Total sqm to be Insulated

• % of Property to be Installed

• Required Material

  Climabead Carbon

  Other

• If other please state

• Average Cavity Width

  Select 40mm 45mm 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm 100mm+

  • 40mm
  • 45mm
  • 50mm
  • 55mm
  • 60mm
  • 65mm
  • 70mm
  • 75mm
  • 80mm
  • 85mm
  • 90mm
  • 95mm
  • 100mm
  • 100mm+

• Please state correct average Cavity width

• Please select elevations to be installed

  Select Front Rear Left Right Extension

  • Front
  • Rear
  • Left
  • Right
  • Extension

• Front Boroscope Photo

  Media

• Front DPC Photo

  Media

• Cavity Depth Photo

  Media

• Rear Boroscope Photo

  Media

• Rear DPC Photo

  Media

• Left Boroscope Photo

  Media

• Left DPC Photo

  Media

• Right Boroscope Photo

  Media

• Right DPC Photo

  Media

• Extension Boroscope Photo

  Media

• Extension DPC Photo

  Media

• Floor Type

  Solid

  Suspended

  Other

• State floor Type

• Combustion vent Required?

  Yes

  No

• Photo of Appliance requiring Combustion vent

  Media

• Cavity Brush Required?

  Yes

  No

• Number of Cavity Brushes Required

  Select 1 2 3 4 5 5+

  • 1
  • 2
  • 3
  • 4
  • 5
  • 5+

• Adjoining properties insulated?

  Yes

  No

  N/A

• Reason Brushes not required

• Location of Chimneys

  Select Internal External Front Elevation Rear Elevation Side Elevation None

  • Internal
  • External
  • Front Elevation
  • Rear Elevation
  • Side Elevation
  • None

• Location of Flue

  Select Internal External Front Elevation Rear Elevation Side Elevation None

  • Internal
  • External
  • Front Elevation
  • Rear Elevation
  • Side Elevation
  • None

• Additional Notes

• Additional Photos

  Media

LOFT INSULATION

• Scheme

  HHCRO

  FLEX

  ATP

  OTHER

• State type of scheme

• Total Area to be Insulated

• Photo of Loft Hatch

  Media

• Photo of Loft space

  Media

• Existing Insulation

  Yes

  No

  N/A

• Existing Depth

• Ofgem Loft Doc Required

  Yes

  No

• Photo of Loft Doc Close up

  Media

• Photo of Loft Doc in Situ

  Media

• Photo of existing depth

  Media

• Depth to be Added

• Photo of Loft

  Media

• Depth to be Installed

• Down-lights present?

  Yes

  No

• Select Rooms Down-Lights Present

  Select Living Room Dining Room Kitchen Bathroom Bedrooms Other

  • Living Room
  • Dining Room
  • Kitchen
  • Bathroom
  • Bedrooms
  • Other

• Additional room

• Total number of Down-Lights

• Any water tanks need insulating?

  Yes

  No

  N/A

• Large Tank

  Select None 1 2 3 4 5

  • None
  • 1
  • 2
  • 3
  • 4
  • 5

• Medium Tank

  Select None 1 2 3 4 5

  • None
  • 1
  • 2
  • 3
  • 4
  • 5

• Small Tank

  Select None 1 2 3 4 5

  • None
  • 1
  • 2
  • 3
  • 4
  • 5

• Photo of tanks

  Media

• Any Pipework require Lagging?

  Yes

  No

  N/A

• Please state meters of pipework

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

  Yes

  No

• Photo of appliance

  Media

• Photo of Power Switch

  Media

• Loft Hatch needing D/P

  Yes

  No

  N/A

• Relay Required?

  Yes

  No

• Relay Sqm

  Yes

  No

• Areas to be omitted

  Yes

  No

• Total area to be omitted

• Loft Vents required

  Yes

  No

  N/A

• Walkway required

  Yes

  No

  N/A

• Mtrs Required

• Loft Clearance

  Yes

  No

• Additional Notes

• Additional Photos

  Media

• Are we installing CWI and/or Loft Insulation?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Media

• Are installing Radbots on the radiators?

  Yes

  No

  N/A

• Are the radiators in good condition?

  Yes

  No

  N/A

• Are any radiators in good condition?

  Yes

  No

  N/A

• 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.

  Yes

  No

  N/A

• Which rooms are suitable for RadBots

  Select Living Room Dining Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5 Hallway Landing Kitchen Bathroom En Suite Utility Room

  • Living Room
  • Dining Room
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5
  • Hallway
  • Landing
  • Kitchen
  • Bathroom
  • En Suite
  • Utility Room

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

  Yes

  No

  N/A

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

  Media

• Can TRV's be fitted on the radiators?

  Yes

  No

  N/A

• What is the size of the pipework?

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

  Media

• When was the boiler last serviced?

• Do all radiators heat up properly

  Yes

  No

  N/A

• Which radiators don't heat up properly?

  Select Living Room Dining Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5 Hallway Landing Kitchen Bathroom En Suite Utility Room

  • Living Room
  • Dining Room
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5
  • Hallway
  • Landing
  • Kitchen
  • Bathroom
  • En Suite
  • Utility Room

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

  Yes

  No

  N/A

• Are we installing CWI and/or Loft Insulation?

  Yes

  No

  N/A

• Do the windows and door require draught proofing?

  Yes

  No

  N/A

• Please provide images of doors/windows that require DP

  Media

• Do the radiators require reflective panels?

  Yes

  No

  N/A

• 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.

  Media

• Are there any open fireplaces/chimneys in the property

  Yes

  No

  N/A

• Are the fire places in use?

  Yes

  No

  N/A

• Can we install a chimney balloon?

  Yes

  No

  N/A

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

  Media

• Are all the lightbulbs low energy?

  Yes

  No

  N/A

• How many are not low energy

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

  Yes

  No

  N/A

• How many light bulbs require an upgrade?

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

  Media

• Are we installing CWI and/or Loft Insulation?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Please provide images of each extraction fan.

  Media

• What rooms do not have extractor fans?

  Select Kitchen Bathroom Bathroom 2 En Suite 1 En Suite 2 En Suite 3 Utility room

  • Kitchen
  • Bathroom
  • Bathroom 2
  • En Suite 1
  • En Suite 2
  • En Suite 3
  • Utility room

• Do any wet rooms have extractor fans?

  Yes

  No

  N/A

• Which wet rooms have extractor fans?

  Select Kitchen Bathroom Bathroom 2 En Suite 1 En Suite 2 En Suite 3 Utility room

  • Kitchen
  • Bathroom
  • Bathroom 2
  • En Suite 1
  • En Suite 2
  • En Suite 3
  • Utility room

• Please provide images of existing extractor fans

  Media

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

  Yes

  No

  N/A

• What rooms have condensation issues?

  Select Living Room Dining Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5 Hallway Landing Kitchen Bathroom En Suite Utility Room

  • Living Room
  • Dining Room
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5
  • Hallway
  • Landing
  • Kitchen
  • Bathroom
  • En Suite
  • Utility Room

• Have the rooms got trickle ventilation?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

• Can we install trickle ventilation in the windows?

  Yes

  No

  N/A

• What rooms require trickle ventialtion?

  Select Living Room Dining Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5 Hallway Landing Kitchen Bathroom En Suite Utility Room

  • Living Room
  • Dining Room
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5
  • Hallway
  • Landing
  • Kitchen
  • Bathroom
  • En Suite
  • Utility Room

• Please provide images of windows that require trickle ventilation

  Media

• Can we install background ventilation?

  Yes

  No

  N/A

• What rooms require background ventilation?

  Select Living Room Dining Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5 Hallway Landing Kitchen Bathroom En Suite Utility Room

  • Living Room
  • Dining Room
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5
  • Hallway
  • Landing
  • Kitchen
  • Bathroom
  • En Suite
  • Utility Room

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

  Media

• Can we mitigate against the condensation?

  Yes

  No

  N/A

• What is the mitigation of the risk?

• Undertake Risk Assessment

• Type of Works

  Select Cavity Wall Loft

  • Cavity Wall
  • Loft

• Cavity Wall Insulation Risk Assessment Questions

• Overhead Electricity Cables Present?

  Yes

  No

• Does the Property have a Garage?

  Yes

  No

• Does the Property have a Porch?

  Yes

  No

• Does the Property have an Outside Tap?

  Yes

  No

• Does the Property have Finlock Gutters?

  Yes

  No

• Does the Property suggest that Asbestos could be Present?

  Yes

  No

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

  Yes

  No

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

  Yes

  No

• Access from Road/ Around Property

  Good

  Fair

  Poor

  N/A

• Is there any Evidence of Vermin?

  Yes

  No

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

  Yes

  No

• Use of a Mobile Tower Required?

  Yes

  No

• Working on Roof Required?

  Yes

  No

• Vibration Likely?

  Yes

  No

• High Noise Levels Likely?

  Yes

  No

• Working with Wet Cement/ Concrete/ Mortar required?

  Yes

  No

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

  Yes

  No

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

  Yes

  No

• Reversing of Vehicle Required?

  Yes

  No

• Electricity Required?

  Yes

  No

• Housekeeping Required

  Yes

  No

• Distance from Works vehicle to Property

• Will Public Walkway be at Risk?

  Yes

  No

• Is neighbour access required?

  Yes

  No

• Safety Signage required?

  Yes

  No

• Loft Insulation Risk Assessment Questions

• Does the Property suggest that Asbestos could be Present?

  Yes

  No

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

  Yes

  No

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

  Yes

  No

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

  Yes

  No

• Access from Road/ Around Property

  Good

  Fair

  Poor

  N/A

• Is there any Evidence of Vermin?

  Yes

  No

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

  Yes

  No

• Vulnerable Person Present?

  Yes

  No

• Use of Ladders Required?

  Yes

  No

• Manual Handling Required?

  Yes

  No

• Reversing of Vehicle Required?

  Yes

  No

• Electricity Required?

  Yes

  No

• Housekeeping Required

  Yes

  No

• Distance from Works vehicle to Property

• Will Public Walkway be at Risk?

  Yes

  No

• Is neighbour access required?

  Yes

  No

• Safety Signage required?

  Yes

  No

• Electricity Cables present in Loft

  Yes

  No

• Working in Confined Spaces required?

  Yes

  No

• Lone Working?

  Yes

  No

• Use of Scaffold required?

  Yes

  No

• What measures are we installing at this property?

  Select Cavity Wall Insulation Loft Insulation Smart Heating Controls Radbots Draughtproofing Reflective Radiator Panels Chimney Balloon Low Energy Light Bulbs Extractor Fans Trickle Ventilation Background Ventilation

  • Cavity Wall Insulation
  • Loft Insulation
  • Smart Heating Controls
  • Radbots
  • Draughtproofing
  • Reflective Radiator Panels
  • Chimney Balloon
  • Low Energy Light Bulbs
  • Extractor Fans
  • Trickle Ventilation
  • Background Ventilation

• Have you completed an EPC

  Yes

  No

  N/A

• 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?

  Yes

  No

  N/A

• What benefit does the client receive

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

  Yes

  No

  N/A

• 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.

  Sign

• 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?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Clients signature

  Sign

• Assessor name

  Sign