Title Page
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Surveyor name:
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Date of survey:
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Customer name:
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Address:
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Postcode:
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Telephone:
Boiler Information - Proposed
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Make and model:
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Size (kW)
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Recommended sales size:
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Required size:
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Location:
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Recommended manufacturer's clearances?
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All access issues checked (doorway openings, floor types, etc.)?
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Location of nearest domestic cold water supply?
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Preparatory work for boiler area (customer / our responsibilities)?
Boiler Information - Photographs of Proposed Location
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Proposed boiler room (angle 1)
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Proposed boiler room (angle 2)
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Proposed boiler room (angle 3)
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Proposed boiler room (angle 4)
Boiler Information - Existing System
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Make, model and fuel type:
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Size (kW):
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Location:
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Existing boiler to be removed from site?
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What is entailed in removing the boiler?
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Existing flue to be removed?
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What is required to make good post flue removal?
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Does existing heating system work?
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What remedials are required?
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What is the age of the existing boiler / heating system?
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What heat emitters are being used?
- Radiators
- Warm air heaters
- Radiant heaters
- Under floor heaters
- Electrical heaters
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What type(s) of radiator?
- Steel panel
- Cast iron
- Aluminium
- Bathroom
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Do all of the radiators work?
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What type(s) of warm air heater?
- Natural convectors
- Fan convectors
- Unit heaters
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What type(s) of radiant heater?
- Metal radiant panels
- Metal radiant strips
- Metal radiant ceilings
- Gas radiant heaters
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What type(s) of underfloor heating?
- Piped underfloor heating
- Electrical underfloor heating
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What type(s) of electrical heating?
- Electrical tubular heating
- Storage heaters
- High temperature heaters
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Do all of the radiators work?
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Is the current system in good condition?
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What is the total number of washrooms?
Boiler Information - System Photographs
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Existing boiler (where fitted):
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Boiler plate (where possible):
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Existing pipe work :
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Pumps and zone valves (where fitted and accessible):
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Hot water cylinder (if adjacent):
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Access to outside:
Fuel Store - Proposed
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Fuel store required?
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Fuel store size:
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Fuel store location (must be adequate size for store):
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Fuel store type (external / fabric bag, etc.):
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Dimensions of recommended fuel store:
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Location of fuel store:
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Feed system:
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Distance between the fuel store and the boiler/day hopper:
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Is there access for the refuelling vehicle?
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Does the customer require extended filling pipes?
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How much hose is required?
Proposed Fuel Store - Photographs
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Ground type:
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Interior angle 1:
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Interior angle 2:
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Interior angle 3:
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Interior angle 4:
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Exterior obstructions?
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Exterior obstruction 1:
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Exterior obstruction 2:
Proposed Buffer - Details
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Buffer tank required?
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Buffer tank location:
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Buffer tank size (ltr)
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Dimensions of the buffer tank location:
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Details of any access issues:
Proposed Buffer - Photographs
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Space for buffer:
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Entryway to room:
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Path from outside doorways, etc.
Proposed Expansion Vessel - Details
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Size (ltrs)
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Location:
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Location dimensions:
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Expansion vessel dimensions:
Proposed Expansion Vessel - Photographs
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Location:
Cylinder - Details
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Existing system:
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Cylinder required?
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Size:
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Type:
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Location:
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Cylinder dimensions:
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Cylinder location dimensions:
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Any access issues?
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Details of any access issues:
Cylinder - Photographs
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Proposed cylinder location:
Flue - Details
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Flue data plate:
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Flue location:
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Height of flue:
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Colour of flue:
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Roof pitch:
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Overhang size:
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Extractor fan required?
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Access issues?
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Is MEWP (i.e. cherry picker) required?
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Is the location clear of obstructions?
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Do trees need removing?
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List of flue parts (including insulation where flue liner required):
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Core drilling issues?
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Details of the issues:
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Location of additional ventilation:
Flue - Photographs
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Inside location:
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Outside location:
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External hazards (trees / high banks / buildings):
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Location of possible vents from outside:
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Exterior vent positions:
Electrics and Controls - Details
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Hard wired or internet interface required:
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Earth bonding present (water and gas)?
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Consumer unit type:
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Is mains electric present at the boiler location?
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Is there RCD protection to existing heating system?
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Existing heating system:
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New boiler location:
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New buffer location:
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Duct work required for underground wiring?
Electrics and Controls - Photographs
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Main consumer unit:
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Close ups of breaker(s):
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Close up of main breaker:
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Close up of main fuse (where old):
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Mains power in proposed boiler location:
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Timer:
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Thermostat:
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Cylinder stat:
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Immersion heater:
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Zone valves (where fitted):
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3 way valve (where fitted):
Groundworks - Details
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Concrete base required?
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Concrete base dimensions:
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Location of concrete base
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Trench required?
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Length of trench:
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Route of trench:
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Heat cabin required?
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Heat cabin location:
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Heat cabin dimensions:
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Mini digger required?
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Ground suitable for a mini digger?
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Size of mini digger required:
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Access clear for a mini digger?
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Concrete mixer required?
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Delivery of concrete required?
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Is access clear for a concrete mixer?
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Is a skip required?
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Agreed location for skip:
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Size of skip required:
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Groundworks overview, including reinstating:
Groundworks - Photographs
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Area for groundworks:
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Area for trenching:
Health & Safety and Planning
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Evidence of asbestos on site?
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Details of asbestos location(s)
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Is the property in a conservation area?
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Is the property listed?
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Could planning be an issue?
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Provide details of why planning could be an issue:
Health & Safety and Planning - Photographs
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Photographs of any planning concerns:
Installation - Details
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Works to be completed by the customer prior to installation:
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Can equipment be delivered prior to installation?
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Provide details of where equipment can be delivered to and securely stored:
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Is access suitable for 7.5 tonne vehicle?
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Is installer parking available at location?
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Is on-street parking available?
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On-street parking details:
- Free parking
- Disk parking
- Metered (coins)
- Metered (cards)
- Resident permit
Installation - Details
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Recommended timescales for installation (days)
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Anticipated down time for hot water / heating during installation (please advise customer):
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Will auxiliary heating be required during the installation period?
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Quantity of heaters required:
Additional Items - Details
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Is there an oil tank at the property that requires removal?
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Size of oil tank:
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Oil tank type:
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Any access issues for removal?
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Provide details of access issues:
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Additional radiators required?
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Radiator model:
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Radiator type(s)
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Radiator size(s)
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Radiator kW rating:
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Radiator quantities:
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TRVs
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Make and model of TRVs
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Quantity of TRVs
Additional Items - Photographs
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Oil tank for removal:
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Room(s) where radiator(s) are to be installed:
Schematic of Existing Boiler and Heating Layout
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Existing boiler and heating layout:
Schematic of Proposed Boiler and Heating Layout
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Proposed boiler and heating layout:
Additional Notes
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Additional notes:
Consumables
Items
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CB end feed straight coupling 15mm quantity:
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CB end feed 90D elbow 15mm quantity:
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CB end feed 90D equal tee 15mm quantity:
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CB end feed straight coupling 22mm quantity:
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CB end feed 90D elbow 22mm quantity:
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CB end feed 90D equal tee 22mm quantity:
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CB end feed straight coupling 28mm quantity:
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CB end feed 90D elbow 28mm quantity:
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CB end feed 90D equal tee 28mm quantity:
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CB end feed fitting reducer 22x15 quantity:
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CB end feed reducer 28x15 quantity:
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CB end feed fitting reducer 28x22 quantity:
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Centre 22mm WRAS LVR brass ball valve quantity:
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Centre 28mm WRAS LVR brass ball valve quantity:
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Compression ball valves (ballaffix) 15mm quantity:
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Tradefix filling loop 15mm WRAS APP quantity:
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15mm MT plug type A (10) quantity:
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Jet auto air vent c/w stopcock quantity:
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CB compression stop end quantity:
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Blk mall bush - 140 1.1/4x1 quantity:
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Blk mall bush - 140 1.1/2x1 quantity:
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Blk mall bush - 140 1.1/2x1/2 quantity:
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Blk mall bush - 140 1x3/4 quantity:
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Blk mall plug - 147 1.1/2 quantity:
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M10251 Blk mall plug - 147 1/2 quantity:
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CB Compression MI Tpr Str Con 15x1/2 quantity:
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CB Compression MI Tpr Str Con 22x3/4 quantity:
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CB Compression MI Tpr Str Con 28x1 quantity:
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CB Compression FI Str Connector 15x1/2 quantity:
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CB Compression FI Str Connector 22x3/4 quantity:
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CB Compression FI Str Connector 28x1 quantity:
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CB Compression Stop Ends 15mm quantity:
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CB Compression Stop Ends 22mm quantity:
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CB Compression Stop Ends 28mm quantity:
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Yorkex 15mm copper tube (3m) per mtr quantity:
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Yorkex 22mm copper tube (3m) per mtr quantity:
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Yorkex 28mm copper tube (3m) per mtr quantity:
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Inhibitor quantity:
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Control system (make/model/type):
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Thermostat:
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Plastic pipe and fitings (size):
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Expansion vessel (size):
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CO alarm:
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NTC probe and pocket
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ESBE valve (size):
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Lagging (length and thickness):
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Zone valves (type/size):
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Pump (type/size):
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Water cylinder (type/size):
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Cylinder kit:
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Central heating cleaner:
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Upinor pipe (length/size/type):
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Additional items not listed above:
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EES representative signature:
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Select date