DCUK FM Damp and Mould Inspection Form

• Document No.

• Audit title

• Surveyor

• Date of Inspection

  Date

• Status of property (occupied or vacant)

• Resident's name

• Resident's contact number

• Address of property
  Address

• Photos

  Media

DAMP AND MOULD INSPECTION REPORT

• Protection of any contents that cannot be removed (with photos of condition);

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• Reported defect

Room 1

• 1.1 Room/Location mould attached to

• 1.2 Nature of complaint

• 1.3 Relative Humidity Reading

  Select Gas Central Heating with TRVs Electric Oil

  • Gas Central Heating with TRVs
  • Electric
  • Oil

• 1.4 Temperature

  Yes

  No

  N/A

• 1.5 Type?

• 1.6 Air Flow Reading

  Yes

  No

  N/A

• 1.7 Windows opening or trickle vents

  Select Double Glazed Single Glazed uPVC Timber Aluminium

  • Double Glazed
  • Single Glazed
  • uPVC
  • Timber
  • Aluminium

• 1.8 Damp-Humidity source

  Yes

  No

  N/A

• 1.9 Inspection findings:

• 1.10 Mould (Condition) Type

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 1.11 Recommended remedial controls

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 1.12 Summary Conclusion / Outcome

• 1.13 Actions and urgency

Room 2

• 2.1 Room/Location mould attached to

• 2.2 Nature of complaint

• 2.3 Relative Humidity Reading

  Select Gas Central Heating with TRVs Electric Oil

  • Gas Central Heating with TRVs
  • Electric
  • Oil

• 2.4 Temperature

  Yes

  No

  N/A

• 2.5 Type

• 2.6 Airflow reading

  Yes

  No

  N/A

• 2.7 Windows opening or trickle vents

  Select Double Glazed Single Glazed uPVC Timber Aluminium

  • Double Glazed
  • Single Glazed
  • uPVC
  • Timber
  • Aluminium

• 2.8 Damp-Humidity source

  Yes

  No

  N/A

• 2.9 Inspection findings:

• 2.10 Mould (Condition) Type

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 2.11 Recommended remedial controls

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 2.12 Summary Conclusion / Outcome

• 2.13 Actions and urgency

Room 3

• 3.1 Room/Location mould attached to

• 3.2 Nature of complaint

• 3.3 Relative Humidity Reading

  Gas Central Heating with TRVs

  Electric

  Oil

• 3.4 Temperature

  Yes

  No

  N/A

• 3.5 Type

• 3.6 Airflow reading

  Yes

  No

  N/A

• 3.7 Windows opening or trickle vents

  Double Glazed

  Single Glazed

  uPVC

  Timber

  Aluminium

• 3.8 Damp-Humidity source

  Yes

  No

  N/A

• 3.9 Inspection findings:

• 3.10 Mould (Condition) Type

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 3.11 Recommended remedial controls

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 3.12 Summary Conclusion / Outcome

• 3.13 Actions and urgency

Room 4

• 4.1 Room/Location mould attached to

• 4.2 Nature of complaint

• 4.3 Relative Humidity Reading

  Gas Central Heating with TRVs

  Electric

  Oil

• 4.4 Temperature

  Yes

  No

  N/A

• 4.5 Type

• 4.6 Airflow reading

  Yes

  No

  N/A

• 4.7 Windows opening or trickle vents

  Double Glazed

  Single Glazed

  uPVC

  Timber

  Aluminium

• 4.8 Damp-Humidity source

  Yes

  No

  N/A

• 4.9 Inspection findings:

• 4.10 Mould (Condition) Type

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 4.11 Recommended remedial controls

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 4.12 Summary Conclusion / Outcome

• 4.13 Actions and urgency

Room 5

• 5.1 Room/Location mould attached to

• 5.2 Nature of complaint

• 5.3 Relative Humidity Reading

  Gas Central Heating with TRVs

  Electric

  Oil

• 5.4 Temperature

  Yes

  No

  N/A

• 5.5 Type

• 5.6 Airflow reading

  Yes

  No

  N/A

• 5.7 Windows opening or trickle vents

  Double Glazed

  Single Glazed

  uPVC

  Timber

  Aluminium

• 5.8 Damp-Humidity source

  Yes

  No

  N/A

• 5.9 Inspection findings:

• 5.10 Mould (Condition) Type

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 5.11 Recommended remedial controls

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 5.12 Summary Conclusion / Outcome

• 5.13 Actions and urgency

Room 6

• 6.1 Room/Location mould attached to

• 6.2 Nature of complaint

• 6.3 Relative Humidity Reading

  Gas Central Heating with TRVs

  Electric

  Oil

• 6.4 Temperature

  Yes

  No

  N/A

• 6.5 Type

  Yes

  No

  N/A

• 6.6 Airflow reading

  Yes

  No

  N/A

• 6.7 Windows opening or trickle vents

  Double Glazed

  Single Glazed

  uPVC

  Timber

  Aluminium

• 6.8 Damp-Humidity source

  Yes

  No

  N/A

• 6.9 Inspection findings:

• 6.10 Mould (Condition) Type

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 6.11 Recommended remedial controls

  Condition 1

  Condition 2

  Condition 3

  Condition 4

  N/A

• 6.12 Actions and urgency

• 6.13 Summary Conclusion / Outcome

Conclusion

• Schedule of work to be carried out at the property

• 1.1 Nature of complaint requires work

  Yes

  No

  N/A

• 1.1 Description of the works:

• SOR code:

• Quantity:

• Works order (priority):

• 2.1 Nature of complaint requires work

  Yes

  No

  N/A

• 2.1 Description of the works:

• SOR code:

• Quantity:

• Works order (priority):

• 3.1 Nature of complaint requires work

  Yes

  No

  N/A

• 3.1 Description of the works:

• SOR code:

• Quantity:

• Works order (priority):

• 4.1 Nature of complaint requires work

  Yes

  No

  N/A

• 4.1 Description of the works:

• SOR code:

• Quantity:

• Works order (priority):

• 5.1 Nature of complaint requires work

  Yes

  No

  N/A

• 5.1 Description of the works:

• SOR code:

• Quantity:

• Works order (priority):

• 6.1 Nature of complaint requires work

  Yes

  No

  N/A

• 6.1 Description of the works:

• SOR code:

• Quantity:

• Works order (priority):