Customer Heat Pump Technical Survey

• Site conducted

  Select

• PNG Number (NISEP Only)

• Address Line 1

• Address Line 2

• Town

• Postcode

• Location of Survey
  Address

• What is the flow rate at the property (20L/min needed)

• Current type of heating installed?

  Select

• Type of Existing Oil Tank - single skin?

  Yes

  No

  N/A

• Type of existing Oil Tank - double bunded?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• How much Oil is remaining in the Oil Tank (litres)?

• Does the customer want us to remove the Oil Tank at the time of installation?

  Yes

  No

  N/A

• Is there access to remove Oil Tank? Take photos and add notes to demonstrate

  Select Yes No N/A

  • Yes
  • No
  • N/A

Inspection of existing plumbing in property:

• Estimated age of existing plumbing system (years)

• Size of existing pipework?

• Any visible defects identified on existing domestic hot and cold pipework?

  Yes

  No

  N/A

• Any visible leaks on any of existing fittings?

  Yes

  No

  N/A

• Is lead pipework present on existing domestic pipework?

  Yes

  No

  N/A

• Are any remedial works required to existing domestic plumbing prior to installation of new heating system? If "Yes" - please give details in Notes

  Yes

  No

  N/A

• Radiator Make and Model?

• If there is a hot water cylinder what size is it? please attach photograph of existing Cylinder

• Is there a back boiler?

  Yes

  No

  N/A

• what action to be taken to existing back boiler?

  Select Yes No N/A

  • Yes
  • No
  • N/A

Existing Building Fabric:

• Does the customer have house plans?

  Yes

  No

  N/A

• External Wall Details

• Internal Wall Details

• Type of Floor?

• Type of Intermediate Floors?

• Type of Roof?

• Type of Roof insulation?

• Type of Windows installed?

• Type of Doors?

Electrical Supply:

• Is there access to meter box? Please attach photos of the meter cabinet

  Yes

  No

  N/A

• Is there access to the consumer unit? and Is there space for new consumer unit on Meter Board? please attach photos

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Yes

  No

  N/A

Heat Pump Items:

• Where will the Heat Pump be sited?

• Underground Pipes or Cabling required?

  Yes

  No

  N/A

• Please provide details of requirement including approx. length in metres. Also attach photographs

• What Expansion Vessel size is needed?

• How many rads is there and what pipework is needed?

• Please complete heat loss study and attach here

  Yes

  No

  N/A

• Please complete room layout and attach here

  Yes

  No

  N/A

• Please give details of the phone signal available and attach phone screenshot (NISEP Only)

• Survey Completed by

  Sign