Information

  • Audit Title

  • Conducted on

  • Prepared by

Tenant/Homeowner Details

  • Name

  • Address
  • Phone Number

  • Mobile Number

  • Email Address

  • Preferred Time of Contact

  • Preferred Contact Method

Client/Landlord Details

  • Name

  • Address
  • Phone Number

  • Mobile Number

  • Email Address

  • Preferred Method of Contact

  • Preferred Time of Contact

Property details

Property Details

  • Property Type

  • Building finish

  • Number of Bedrooms

  • Type of Heating

  • Structural condition

  • External Wall Condition

  • Adequate ventilation to work area

  • Dampness or water damage

  • Photo of each elevation

  • Building defects

  • Special Instructions

Access

  • On site parking

  • Client Instructions

  • Access Issues

  • Access Equipment Required

Foam Extraction

  • Total area to be extracted

  • Reason for extraction

  • Has client been advised on extent on drilling and core holes

  • All vents cavity, underfloor, pantry, bedroom and combustion vents identified?

  • Photos of all vents to be sealed internally

  • Is the main heating appliance flue'd through an external wall?

  • Photos of main heating appliance and flue

  • Are all windows throughout the property adequately sealed to prevent ingress of dust ?

  • Photos of all window reveals sealed throughout the property

  • Are there any hairline cracks on the internal leaf of all external walls where dust may ingress?

  • Photos of all hairline cracks on internal leaf of external walls

  • Are all areas behind household appliances on external walls checked for areas of ingress?

  • Photos of wall areas behind household appliances

  • Are there any built in wardrobes on external walls?

  • Photo of built in wardrobes

  • Has the client been informed of the requirement for the technicians to complete a thorough seal up of the property prior to extraction works commencing?

  • Has the client been made aware of all issues that may arise from the extraction of foam insulation in relation to dust ingress?

Condensation and Ventilation and Other Property Issues

Condensation or Damp Issue

  • Add media

Other Property Issues

  • Add media

Dynamic Risk Assessment & Client Declaration

Dynamic Risk Assessment

  • I have assessed the overall condition of the property ensuring it's suitability for extraction. Whilst every possible precaution is taken to seal up prior to any extraction works being started, it is not possible to ensure that dust and debris will not ingress in to your property where previous trades have completed works on your property. Unless listed below, there are no additional significant hazards observed that are not addressed in the generic risk assessment for the work to be undertaken.<br>

  • Assessors signature

  • Client 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.