Air Source Heat Pump Survey

• Conducted on

  Date

• Prepared by

• Location
  Address

• Clients Name

• Address

• Contact Number

• Email Address

• EPC Completed on the Property

  Yes

  No

  N/A

• Known Date of EPC

  Yes

  No

  N/A

• Property Type

  Flat

  Bungalow

  Semi Detached

  Detached

  Terrace

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• Number of Bedrooms

  Select 1 2 3 4 5 6+

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6+

• Age

• Construction

  Brick

  Stone

  Timber Frame

  Other

• Cavity

  Yes

  No

  N/A

• Cavity Insulated

  Yes

  No

  N/A

• Window Construction

  Plastic

  Wood

  Other

• Roof Construction

  Slate

  Tiled

  Thatched

  Other

• Plans Provided (if yes, please forward via email, including questionnaire)

  Yes

  No

  N/A

• Property Size

• Height (Floors)

  Select 1 2 3 4 5 6+

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6+

• Width (Meters)

• Length (Meters)

• Existing Heating

  Select Electric Storage Electric Boiler Combination Boiler Boiler & Cylinder ASHP GSHP

  • Electric Storage
  • Electric Boiler
  • Combination Boiler
  • Boiler & Cylinder
  • ASHP
  • GSHP

• Fuel Source

  Select Oil Gas Electric (Single Phase) Electric (3 Phase) LPG Coal Wood

  • Oil
  • Gas
  • Electric (Single Phase)
  • Electric (3 Phase)
  • LPG
  • Coal
  • Wood

• Heat Emmitters

  Radiators

  Underfloor Heating

  Electric Storage

  Other

• Number of Bathrooms

• Number of Shower Mains Water

• Number of Showers Electric