Bell Quantum Survey

Title Page

Details

Conducted on
Prepared by
Name
Client and Tenure
- Exeter City Council
- Shal Housing
- Rooftop
- Alliance Homes
- East Devon Homes
- Abri
- Magna
- Celtic Horizons
- Selwood
- Live West
- Peabody
- Curo
- Owner Occupier
- Privately Rented
- Other
Who?
Survey Type
First Line of Address
Front Elevation Photo
What3Words Location
GPS

Dynamic Risk Assessment

Access Assessment

Do you give consent for us to carry out works within your property ?
Reasoning?
Is parking available, adequate for the size of vehicle and close to the property ?
Comments,
Photographic evidence
Do parking restrictions exist i.e. Residents parking ?
Comments
Photographic evidence

Occupant Assessment

Is the property in a suitable condition for the proposed works to be carried out ?
Comments
Photographic evidence
Is the property highlighted as flagged or at risk ?
Comments
Do the occupants have any physical disabilities that pose any significant risks ?
Comments
Do the occupants have any learning difficulties where our activities may pose any significant risks ?
Comments
Are there any potential risks regarding minors in the property ?
Comments
Are there any potential risks regarding pets in the property ?
Comments
Is the property high risk of biological waste or vermin ?
Comments
Photographic evidence
Is the property at high risk of hypodermic needles ?
Comments

Asbestos Assessment

Are we in receipt of or have access to the asbestos survey or register for this property ?
Asbestos Assessment Needs to be Checked
Comments
Has asbestos been identified ?
Comments
Photographic evidence

Section 1

Customer Details

Resident Name
Resident Contact Number
Resident Email
Best Days for Installation / Days to Avoid
Current Energy Supplier
- Utilita
- British Gas
- EON
- EDF
- Octopus
- OVO
- nPower
- Scottish Power
- Boost
- Other
- Unknown
Which Supplier?
Company Type
Project Type
What Type

Section 2

Property Type
Please Specify
Wall Type
- Cavity Wall (No Insulation)
- Cavity Wall (Insulated)
- Solid Brick
- System Built
- Metal Frame
- Other
Floor Type
Roof Insulation
- 0mm
- 12mm
- 25mm
- 50mm
- 70mm
- 80mm
- 100mm
- 125mm
- 150mm
- 170mm
- 200mm
- 250mm
- 270mm
- 300mm plus
Glazing Type
Property Age
- A - Pre 1900
- B - 1900 - 1929
- C - 1930 - 1949
- D - 1950 - 1966
- E - 1967 - 1975
- F - 1976 - 1982
- G - 1983 - 1990
- H - 1991 - 1995
- I - 1996 - 2002
- J -2003 - 2006
- K - 2007 - 2011
- L - 2012 onwards
Heating System Required
What Type
Water Heating Req
Electrical Supply
Main Heating Type?
- Mains Gas
- Oil
- Solid Fuel
- Electric
- Heat Pump
- LPG
- Heating not working at the time of survey
- Other
Boiler Type
Type?
Boiler Model
What Model?
Boiler Location
What Location?
Heating Controls Type
Heating Controls Location
Where
New Heating Control Proposed Location
Where?
Photographic Evidence
What Type
What Type
- Old Storage Heaters
- High Heat Retention (Quantums)
- Panel Heaters
- Portable Heaters
- Other
Heat Pump Type
Secondary Heat source?
- No other heating present
- Electric Effect Fire
- Gas Fire with Flue
- Gas Fire with chimney
- Gas Fire Flush Fitted
- Open Fire with internal chimney
- Open Fire with external chimney
- Wood Burner
- Other
Photographic Evidence
BBU Removal Required
Photographic Evidence

Existing Heating

How Many Storage Heaters/Radiators Need to be Removed?
Storage Heater Serial Number (For Asbestos Purposes)
Loft Water Tank Removal
Fuse Board and Main Fuse Cut Out Rating
Is the mains service looped? (2 cables, 1 coming out to neighbours propoerty)
Photographic Evidence
Smart Meter Installed?
Electric Meter Photographic Evidence

Cylinder Cupboard

Door Size
Cupboard Depth, Width & Height
Photographic Evidence of Cylinder Cupboard
What Size of Cylinder Will Fit
How will the Dischage Pipe Route to Outside be done
Existing Cylinder Type

Section 3

Attach Floorplan Showing Individual Room Sizes and Ceiling Height
Living Room
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Hallway
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Dining Room
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Upper Floor Hallway/Landing
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Bedroom 1
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Bedroom 2
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Bedroom 3
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Bedroom 4
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Bedroom 5
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Study
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Kitchen
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Bathroom
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
W/C
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Other Specify
What Room
Floor Area (m2)
Ceiling Height (m)
External Wall Length (m)
Window Area (m2)
External Door Area (m2)
Will there be a heated room/space
Max Space Available for Radiator (Length, Height)
Floor Level
Required Room Heater/Emitter Type
Existing Heater
Photo
Heater Size
Job Requirements

Declarations

Customer Declaration

DECLARATION: I understand what what is due to be carried out and I agree to the positions of the pipe-work, radiators, cylinder, external unit and room thermostat.
I agree to the use of the welfare facilities in my property
Customer Signature