Title Page

  • Office Location:

  • Date survey conducted:

  • Client:

  • Address (incuding postcode):

  • Name of PFP representative undertaking survey

  • Name of MD representative undertaking survey

  • Customer Name:

  • Customer contact number(s):

  • Customer e-mail address:

  • UPRN Number:
  • Job Number:

  • Any Notification?

  • Open Disrepair Claim?

Existing heating system in property

  • Existing heating system in property: Gas?

  • Please specify

  • Boiler location

  • Primary heating within kitchen / bathroom

  • Do radiators require changing?

  • Length of radiator (M)

  • Height of radiator (M)

  • Single or double?

Kitchen - Construction of floor

  • Floor Construction

  • Please specify

  • Does the floor need to be replaced?

  • What is the overall size that needs to be replaced? (SQM)

  • Do any floor joists need to be replaced?

  • Please provide quantity and sizes.

Construction of ceiling

  • Ceiling Construction

  • Please specify

  • Does the ceiling need to be replaced?

  • What is the overall size in (SQM) that needs to be replaced

  • Does the ceiling need to be skimmed?

  • What is the overall size in (SQM) that needs to be skimmed?

Kitchen Stop tap location

  • Location of stop tap

  • Is the stop tap functioning correctly?

  • Does stop tap need replacing?

  • Is a block shut down if required?

Kitchen Dimensions

  • Length (M)

  • Width (M)

  • Height (M)

  • Overall SM2 of Kitchen.

  • Additional notes:

  • Kitchen Size

  • Please specify:

  • Kitchen Sink

  • Up stands

  • Kitchen taps

  • Please specifiy:

  • Fit new CO2 detector?

  • New install of electric fan?

  • Wall or ceiling?

  • Upgrade wall fan?

  • Upgrade ceiling fan?

  • Renew ceiling light?

  • Renew sockets & switches?

  • Paint ceiling?

  • Strip wallpaper?

  • Additional notes / SM2

  • Paint walls

  • Re-plaster walls

  • Additional notes / SM2

  • Paint Woodwork?

  • Renew skirting board?

  • Additional notes / LM

  • Renew window board

  • Length & Width

  • Overall size of new flooring (SM2)

CUSTOMER FIXTURES AND FITTINGS NOT TO BE DISCARDED, CUSTOMER TO REMOVE ALL ITEMS FROM THE KITCHEN.

  • Please add any notes regarding fixtures / fittings of customers, and what has been agreed.

  • All agreed variations at survey stage to be recorded below.

  • PFP, signature

  • Mdgroup, signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.