Title Page
Property Details
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Surveyor Name
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Date of visit
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Property Address
Inspection Details
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Nature of the concern that has been raised:
Hallway
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences - eves, guttering, roof etc:
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Details of any internal influences - leaks, poor ventilation, lack of heating etc:
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Details of any other contributing factors:
Lounge
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences - eves, guttering, roof etc:
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Details of any internal influences - leaks, poor ventilation, lack of heating etc:
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Details of any other contributing factors:
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Kitchen
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Is there a fan present?
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Does this work?
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Type of fan (Envirovent etc)
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Photo of fan
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors - cooking with doors open/ not using lids etc:
Bathroom
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Humidity level if recorded:
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Is there extraction/fan present?
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Is it powered at the time of the visit?
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Photo of the fan
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Is the fan working correctly?
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Type of fan
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors:
Bedroom 1
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors:
Bedroom 2
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors:
Bedroom 3
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors:
Bedroom 4
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors:
Bedroom 5
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Any signs of damp or mould found?
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Damp or mould?
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Location and severity of the dampness/mould found:
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Room Temperature if taken:
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Humidity level if recorded:
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Details of any external influences:
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Details of any internal influences:
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Details of any other contributing factors:
Loft
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Summary of condition of loft including insulation details
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Relevant photos:
Externals
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Summary of externals
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Relevant photos:
Vulnerabilities for anyone residing at the property
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Babies
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Children under 14
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Elderly persons
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Breathing conditions such as asthma
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Details of condition
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Skin conditions (eczema etc)
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Details of condition
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Alergies
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Details of allergy
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Weakened immune system (chemotherapy etc)
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Details
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Any other issues (such as poverty, overcrowding, other vulnerabilities)
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Summarise details
Follow on actions
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Are remedial/follow on works required?
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Summary of works
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Is a further specialist report required?
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Seriousness of issue