Bathroom Survey

• Document No.

• Audit Title

• Location
  Address

• Conducted on

  Date

• Prepared by

  Select GERRY CLAXTON IAN STROULGER ANDREW GWILLIAM CHRIS BOYD MARK GODDEN DAN GIPP CHRIS TODD

  • GERRY CLAXTON
  • IAN STROULGER
  • ANDREW GWILLIAM
  • CHRIS BOYD
  • MARK GODDEN
  • DAN GIPP
  • CHRIS TODD

Replacement Detail

• When does the bathroom require replacement?

  Select 2017 Programme 2018 Programme 2019 Programme 2020 Programme After 2020

  • 2017 Programme
  • 2018 Programme
  • 2019 Programme
  • 2020 Programme
  • After 2020

• If tenant requests that the bathroom is Not replaced have you gained a signed disclaimer from tenant at your survey?

  Select Yes No

  • Yes
  • No

• Disclaimer to be signed by tenant if they do not want bathroom replaced.

  Sign

Condition Status

• What is the condition of the Bathroom ?

  Select Satisfactory - no repairs or only a few day to day repairs required, no Health & Safety concerns? Potentially Un-satisfactory - several day to day repairs required, and/or some potential Health & Safety concerns? Unsatisfactory - Lots of day to day repairs, some more major repairs and/or some Health & Safety concerns?

  • Satisfactory - no repairs or only a few day to day repairs required, no Health & Safety concerns?
  • Potentially Un-satisfactory - several day to day repairs required, and/or some potential Health & Safety concerns?
  • Unsatisfactory - Lots of day to day repairs, some more major repairs and/or some Health & Safety concerns?

• Is Bathroom to be replaced before the component replacement date?

  Yes

  No

• Photo's of existing bathroom

  Media

Design & Layout

• Bathroom design to be like for like ?

  Select Yes No

  • Yes
  • No

• Vinyl floor area?

• Tenants flooring colour choice

  Select HUDSON GREY ARDOISE BLACK SAVANNAH MEDIUM OFFSET BEIGE HUDSON GREY SHADE MEDIUM GREY

  • HUDSON GREY
  • ARDOISE BLACK
  • SAVANNAH MEDIUM
  • OFFSET BEIGE
  • HUDSON GREY
  • SHADE MEDIUM GREY

• Type of floor

  Solid

  Timber

  Floating floor

• Any flooring repairs required?

  Yes

  No

  N/A

Bathroom components

• 1700 Bath size

  Select 1700 1600

  • 1700
  • 1600

• Sink & pedestal

  Select Yes No

  • Yes
  • No

• Toilet

  Select Close Coupled Low level pan & cistern Raised height pan- close coupled Raised Height pan- low level

  • Close Coupled
  • Low level pan & cistern
  • Raised height pan- close coupled
  • Raised Height pan- low level

• Electric shower required?

  Select Yes No

  • Yes
  • No

• Shower type

  Select Mira Jump Triton T80 Mira Advance Triton Omnicare

  • Mira Jump
  • Triton T80
  • Mira Advance
  • Triton Omnicare

• Mixer shower required

  Select Yes No

  • Yes
  • No

• Bath panel required with end panel

  Select Yes No

  • Yes
  • No

• normal long side bath panel only no ends

  Select Yes No

  • Yes
  • No

• Any boxing in required

• Shower rail required?

  L shaped rail

  Straight rail

• Shower curtain required ?

  Yes

  No

• Shower screen required?

  Yes

  No

• Tiling required?

  Yes

  No

• area of tiling

• Wall Board required?

  Yes

  No

  N/A

Electrics

• Do we need to move or alter light

  Yes

  No

  N/A

• Shaver socket in bathroom

  Yes

  No

  N/A

• Is there an extract fan?

  Yes

  No

  N/A

• Can we install extract fan

  Yes

  No

  N/A

Notes

• Write any additional information here

Completion

• Sign off

  Sign