Title Page
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Conducted on
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Prepared by
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Client Name
Customer Details
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Address
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Postcode
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What3Words (Please visit https://what3words.com and get the what3words for this address)
Property Details
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Property Type
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Number of Bedrooms
- 1
- 2
- 3
- 4
- 5
- 6+
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Age
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Plans Provided (if yes, please forward via email, including questionnaire)
Electrical
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What is the Fuse rating ( DNO PURPOSE )
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Estimate Electrical Load (Amps)
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Picture of Circuit Breaker
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Incoming supply
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Suggested Electrical cable run (Discuss with customer) and add Notes- distance, trenching etc
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Location of Meter
Property Heating
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Existing Heating
- Electric Storage
- Electric Boiler
- Combination Boiler
- Boiler & Cylinder
- ASHP
- GSHP
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Fuel Source
- Oil
- Gas
- Electric (Single Phase)
- Electric (3 Phase)
- LPG
- Coal
- Wood
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Heat Emmitters
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Current Boiler Location and Dimensions
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Current Cylinder Location and Dimensions
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Number of Bathrooms
New System
New System
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How many days will this install Take
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Preferred manufacturer
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New Cylinder size
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New Cylinder Type
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New cylinder location
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Please explain location of controller in relation to pump, cylinder and fuse box
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Please note if the Monobloc is R290 then the location must meet r290 regulations, please confirm suitability of the location of the heat pump in accordance to the regulations
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Proposed heat pump location
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Any issues regarding placement and condensation? if yes please detail
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Does customer require a quotation with radiator changes?
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Distance of cylinder from pump
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Is Trunking required
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If yes Please Detail ()
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Placement of contoller Unit(Picture)
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Type and Size Pipes (Take pictures and draw pipe run and sizes)
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Any material to be ordered?
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Have you completed Sound assessment on HeatEnginer ?
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Survey Pics
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Drawings
