Title Page
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Special Instruction
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Are there any special requirements / restrictions to mention in the property?
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Please state
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Site conducted
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First Line of Address and Postcode
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Conducted on
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Prepared by
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Job Type
TENANT/HOMEOWNER
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Clients Name
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Address
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County
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Clients Date of Birth (if applicable)
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Landline Number
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Mobile Number
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Email Address
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Is Client Main Contact?
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Main Contact Name
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Relationship
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Contact Number
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Preferred Contact
- Landline
- Mobile
- Letter
CLIENT/LANDLORD DETAILS
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Name
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Contact Number
PROPERTY DETAILS
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Property Type
- House
- Bungalow
- Flat
- Maisonette
- Park Home
- Commercial
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Sub Property Type
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Front Elevation
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Rear Elevation
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Right Elevation
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Left Elevation
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Orientation
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Front Elevation
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Rear Elevation
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Left Elevation
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Right Elevation
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Front Elevation
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Rear Elevation
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Right Elevation
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Orientation
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Front Elevation
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Rear Elevation
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Left Elevation
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Front Elevation
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Rear Elevation
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Right Elevation
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Front Elevation
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Rear Elevation
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Number of Storeys
- 1
- 2
- 3
- 4
- 5
- 5+
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State number of storeys
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Number of extensions
- None
- 1
- 2
- 3
- 4
- 5
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Number of Conservatories
- None
- 1
- 2
- 3
- 4
- 5
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Tenure
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State tenure type
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Number Of Bedrooms
- 1
- 2
- 3
- 4
- 5
- 5+
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State number of bedrooms
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Structural Condition
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Photos
ACCESS
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On site Parking
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Client Instructions
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Neighbour Access Required
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Is Neighbour Aware
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Access Issues
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Please list Access Issues
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Photos Of Access Issues
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Access Equipment Required
- Ladders
- Scaffolding
- Conservatory Ladder
- Extraction Lance
- Installation Lance
- Other
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Please State Additional Equipment
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IMAGE OF BASIC FLOOR PLAN
INSPECTION SURVEY
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Survey Type
- EvoBoard
LOFT INSULATION
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Scheme
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State type of scheme
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Total Area to be boarded
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Photo of Loft Hatch
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Size of Loft Hatch
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Height of loft space
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Photo of loft space (showing entire loft inc. joist to rafter)
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Existing Insulation
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Ofgem Loft Doc Required
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Photo of Loft Doc Close up
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Photo of Loft Doc in Situ
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Photo of existing depth
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Who is going to remove the quilt?
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Photo of joist area's clear of insulation
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What is the width of the joist?
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What is the width?
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Down-lights present?
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Select Rooms Down-Lights Present
- Living Room
- Dining Room
- Kitchen
- Bathroom
- Bedrooms
- Other
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Additional room
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Total number of Down-Lights
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High Amp electrical cables present? (e:g; Power Shower, Cooker)
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Photo of appliance
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Photo of Power Switch
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Loft Clearance
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Additional Notes
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Additional Photos
RISK ASSESSMENT
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Undertake Risk Assessment
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Type of Works
- Cavity Wall
- Loft
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Cavity Wall Insulation Risk Assessment Questions
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Overhead Electricity Cables Present?
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Does the Property have a Garage?
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Does the Property have a Porch?
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Does the Property have an Outside Tap?
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Does the Property have Finlock Gutters?
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Does the Property suggest that Asbestos could be Present?
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Confirm you have asked the Client if there was any known Asbestos or Asbestos containing materials within the property
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Do you or the Client have any Reason to suspect Asbestos is present in the Property?
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Access from Road/ Around Property
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Is there any Evidence of Vermin?
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Is there any Evidence of Protected Wildlife? (e.g. Bats)
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Use of a Mobile Tower Required?
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Working on Roof Required?
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Vibration Likely?
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High Noise Levels Likely?
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Working with Wet Cement/ Concrete/ Mortar required?
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Use of Mobile Elevation Working Platform (MEWP) required?
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If Obstructions present, can an extended Lance be used to Remedy?
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Reversing of Vehicle Required?
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Electricity Required?
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Housekeeping Required
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Distance from Works vehicle to Property
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Will Public Walkway be at Risk?
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Is neighbour access required?
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Safety Signage required?
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Loft Insulation Risk Assessment Questions
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Does the Property suggest that Asbestos could be Present?
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Confirm you have asked the Client if there was any known Asbestos or Asbestos containing materials within the property
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Do you or the Client have any Reason to suspect Asbestos is present in the Property?
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Have all checks been Undertaken to determine if Asbestos containing materials are present within the property?
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Access from Road/ Around Property
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Is there any Evidence of Vermin?
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Is there any Evidence of Protected Wildlife? (e.g. Bats)
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Vulnerable Person Present?
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Use of Ladders Required?
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Manual Handling Required?
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Reversing of Vehicle Required?
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Electricity Required?
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Housekeeping Required
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Distance from Works vehicle to Property
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Will Public Walkway be at Risk?
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Is neighbour access required?
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Safety Signage required?
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Electricity Cables present in Loft
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Working in Confined Spaces required?
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Lone Working?
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Use of Scaffold required?
DYNAMIC RISK ASSESSMENT
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I has assessed the conditions on site ensuring there is adequate ventilation. Unless listed below, there are no additional significant hazards observed that are not addresses in the generic risk assessment for the works to be undertaken
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Assessors Name and Signature
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Customer's name and Signature
QUOTATION
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Select Measures for Quotation
- EvoBoard
EXTRACTION
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Total m2
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Price
CAVITY WALL INSULATION
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Total m2
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Price
LOFT INSULATION
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Total m2
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Price
DAMP
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Total m2
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Price
OTHER WORKS
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Type of Works
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Price
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Access Equipment Required
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Access Equipment Required
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Price
