Information
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Audit Title
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Conducted on
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Prepared by
Tenant/Homeowner Details
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Name
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Address
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Phone Number
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Mobile Number
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Email Address
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Preferred Contact Method
- Landline
- Mobile
- Letter
Client/Landlord Details
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Name
Property details
Property Details
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Property Type
- Mid-Terrace
- End terrace
- Semi-detached
- Detached
- Lower Flat
- Middle Flat
- Top Flat
- Maisonette
- Other
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Building finish
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Number of Bedrooms
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Type of Heating
- Gas
- Oil
- Solid Fuel
- Electric
- Other
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Insulation Works Required
- Loft Insulation
- Cavity Wall Insulation
- External Wall Insulation
- Extraction
- Underfloor Insulation
- Internal Wall Insulation
- Ventilation
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Structural condition
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External Wall Condition
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Adequate ventilation to work area
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Dampness or water damage
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Photo of each elevation
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Building defects
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Special Instructions
Access
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On site parking
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Client Instructions
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Access Issues
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Access Equipment Required
- None
- Ladders
- Tower
- Scaffolding
- Cherry Picker
- Scissor lift
- Conservatory Ladder
- Step Ladders
Cavity Wall Insulation
Details
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Test
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Total area to be insulated
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Required material
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Average Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
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Boroscope photo
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Number of Cavity brushes required
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Core vent required
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List any defects
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Photo of any defects
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List all access issues
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Photo of access issues
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Location of chimneys
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- None
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Location of flues
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- None
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Does the property have existing insulation with a residual cavity?
- Yes
- No
- N/A
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Is the residual cavity wall insulation suitable to receive EPS bead?
- Yes
- No
- N/A
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Residual Cavity Width?
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
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Is DPC minimum of 150mm above floor level?
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Photo of DPC level
Extraction
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Total area to be extracted
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Reason for extraction
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Material being extracted
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Recommended cavity drying time
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Are all apertures sealed internally
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Has client been advised on extent on drilling and core holes
Loft Insulation
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Photos of loft
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Area to be insulated
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Existing Depth
- 0mm
- 50mm
- 70mm
- 100mm
- 150mm
- 200mm
- 250mm
- 270mm
- 300mm
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Photo of existing depth
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Depth to be added
- 100mm
- 150mm
- 200mm
- 250mm
- 300mm
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Relay Required
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Loft hatch needing D/P
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Loft vents required
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Areas to be omitted
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Walkway required
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Loft Extraction
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Additional notes
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Please Note All High Powered Cables and Downlights
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Are there existing pipes & tanks in use?
- Yes
- No
- N/A
Condensation and Ventilation and Other Property Issues
Condensation or Damp Issue
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Add media
Other Property Issues
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Add media
Dynamic Risk Assessment & Client Declaration
Dynamic Risk Assessment
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I have assessed the conditions on site ensuring there is adequate ventilation. 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.
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Assessors signature
