Air Source Heat Pump Survey

• Client

• Prepared by

• Extend Reference Number

• Installation address

• Are there any Potential Asbestos Containing Materials present ?

  Yes

  No

  N/A

• Is there a safe workaround to avoid disturbing Asbestos Containing Materials

  Yes

  No

  N/A

• Is Scaffolding Required ?

  Yes

  No

  N/A

• Is Parking available at the Property

  Yes

  No

  N/A

• Are there parking charges in operation

  Yes

  No

  N/A

• Are there any obstructions on or around the Property

  Yes

  No

  N/A

• Are there any animals kept at the property that may be considered dangerous

  Yes

  No

  N/A

• Is there any working at heights involved

  Yes

  No

  N/A

• Will permissions be required for working in a neighbouring Property e.g access to garden

  Yes

  No

  N/A

• Are there any signs of Health Hazards e.g Animal Fowling, discarded needles, excessive rubbish

  Yes

  No

  N/A

• Will there be anyone present within property that would require Respite care

  Yes

  No

  N/A

• Will there be any Children within the property

  Yes

  No

  N/A

• Will any Persons with Visual Impairments or Hearing Difficulties be present

  Yes

  No

  N/A

• Are there any Gas Bottles present within the Property e.g Medical Qxygen

  Yes

  No

  N/A

Detachment Type

• HouseType

  Select Detached End Terrace Mid Terrace G/F Flat 1st Floor 2nd Floor 3rd Floor Semi

  • Detached
  • End Terrace
  • Mid Terrace
  • G/F Flat
  • 1st Floor
  • 2nd Floor
  • 3rd Floor
  • Semi

• Does the Property have a Garage

  Attached

  Detached

• Main Wall Thickness

• EWI Thickness if any

  50mm

  75mm

  100mm

• Main External Wall Construction Type

  Solid

  Cavity

  Cavity Filled

  Timber Kit

• Main External Wall Material Finish

  Stone

  Block and Render/Roughcast

• Internal Wall Type

  Solid Brick/Block

  Plasterboard and Studwork

• Party Wall Type

  Solid

  Cavity

  Cavity Filled

  Timber Kit

  Timber Kit Insulated

• Ground Floor Type

  Solid

  Solid Insulated

  Timber Suspended

  Timber Suspended Insulated

• Intermediate Floor Construction

  Solid

  Suspended Timber

  Suspended Timber Insulated

• Roof Type

  Flat

  Pent

  Pitched

  Mansard

  Room in Roof

• Is Attic insulated

  Select No 50mm 100mm 150mm 200mm 270mm 300mm

  • No
  • 50mm
  • 100mm
  • 150mm
  • 200mm
  • 270mm
  • 300mm

• Is there Insulation within the Rafters

  Yes

  No

  N/A

• Window Type

  Single

  Double

  Triple

• External Door Type

  Solid

  50% Glazing

Photos

• External Wall Thickness

  Media

• Window Type

  Media

• Front Elevation

  Media

• Rear Elevation

  Media

• Side Elevations

  Media

• All Building Photos should be clearly geotagged / time and date stamped .

• Is the property in a Listed or Conservation Area

  Yes

  No

  N/A

• Will the install fall under permitted Development

  Yes

  No

  N/A

• Are there any other planning issues to consider

  Yes

  No

  N/A

• Photo of Heat Pump Location

  Media

• Water management arrangements for condensate from ASHP

Sound Power Level

• Sound Pressure Level

  Select Q2 Standalone 1 reflective surface Q4 Against Wall 2 reflective Surfaces Q8 In corner 3 reflective surfaces

  • Q2 Standalone 1 reflective surface
  • Q4 Against Wall 2 reflective Surfaces
  • Q8 In corner 3 reflective surfaces

• Distance from Heat Pump to Assessment Point

• Is the Assessment point visible from top of the Heat Pump

  Pass

  Fail

  N/A

System Design

• Proposed Heat Pump Type

  ASHP Monoblock

  ASHP Split System

• Will the system be designed for Intermittent Heating

  Yes

  No

  N/A

• Proposed Type of emitters

  Standard Radiators

  UFH

  UFH and Radiators

• What will the system Provide

  Space Heating Only

  Space Heating and Hot Water

  Hot Water Only

• Will an additional Heat Source be required

  Yes

  No

  N/A

• Is the Property in an exposed location

  Yes

  No

  N/A

• What year was the property Built

• Is there a valid EPC available

  Yes

  No

  N/A

• Existing Fuel Type

  Electric Storage

  Gas

  LPG

  Oil

  No Central Heating

• Photo of Fuel Bill

  Media

• Photo of Electricity Bill including MPAN Number

  Media

• Photo of existing Heating Source

  Media

• Photo of existing Domestic Hot Water Cylinder

  Media

• Number of Bedrooms

• Number of Occupants of Property

• Clear Photo of Consumer Unit

  Media

• Are there Spare Ways in the Consumer Unit

  Yes

  No

  N/A

• Clear Photo of Cable Head showing the rating label

  Media

• Type of Earthing System

  TN-C

  TN-S

  TN-C-S/PME

  TT

• Is there an MI Installed

  Yes

  No

  N/A

• Clear Photo of Electricity Meter

  Media

• Is the supply looped

  Yes

  No

  N/A

• Is there Solar PV

  Yes

  No

  N/A

• Please take Photo of PV Array

  Media

• Is there an EVCP

  Yes

  No

  N/A

• Please take Photo

  Yes

  No

  N/A

• Is there an Energy Battery Installed

  Yes

  No

  N/A

• Please take photo

  Media

• Location of Heat Pump

• Are there any alterations to paths required

  Yes

  No

  N/A

• Position of New DHW Cylinder or Sunamp Unit

• Internal dimensions of cupboard where either cylinder or Sunamp is being located

• Is the proposed location suitable for the weight of the Sunamp Units

  Yes

  No

  N/A

• Are there any cupboard alterations required

  Yes

  No

  N/A

• Dimension of Cupboard Door

• Is External Trunking Required

  Yes

  No

  N/A

• Length of Trunking Required

• Primary Flow and Return Pipework distance to DHWC or Sunamp

• Photo of existing Lounge Radiator Location

  Media

• Photo of possible additional Lounge Radiator

  Media

• Photo of existing Kitchen Radiator Location

  Media

• Photo of existing Hall Radiator Location

  Media

• Photo of Toilet radiator

  Media

• Photo of existing Bathroom Radiator Location

  Media

• Photo of existing Bedroom Radiator 1 Location

  Media

• Photo of existing Bedroom 2 Radiator Location

  Media

• photo of en-suite radiator

  Media

• Photo of existing Bedroom 3 Radiator Location

  Media

• Photo of existing Bedroom 4 Radiator Location

  Media

• Photo of existing Landing Radiator Location

  Media

• Photos of any other rooms within the property that require to be Heated along with room information

  Media

• Photos of Floor Coverings Ground Floor

  Media

• Photos of Floor Coverings First Floor

  Media

• Photo of Ground Floor Layout

  Media

• Photo of First Floor Layout

  Media

• Customer name

  Sign

• Customer signature

  Sign