Title Page
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Address
General Details
General Details
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Survey Completed By
- Steve Britton
- Vinnie Stokes
- Alister Paisley
- Billy Wright
- Sean Glossop
- Jeremy Illy
- Other
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Name
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Has a COVID-19 Risk Assessment been conducted ?
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Client
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Resident Name
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Contact Details
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Site Address
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Photo of property
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Date of Survey
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Is the Boiler condensing (modern)
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Please Identify the Make and Model of the Boiler
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Make and Model of Boiler
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Image of Boiler
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Image of Model Identification
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Please Identify the Make and Model of the Boiler
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Make and Model of Boiler
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Image of Boiler
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Image of Model Identification
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Proceed with Full Survey
Survey Details
Property Details
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Property Type
- House
- Bungalow
- Flat
- Maisonette
- Commercial
- Other
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Comments
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Property Attachment
- Semi Detached
- Detached
- Mid Terraced
- End Terraced
- Ground Floor Flat
- Mid Floor Flat
- Top Floor Flat
- Other
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Description of Other
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What is the Overall wall thickness (mm) ?
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Number of Bedrooms
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Select Occupancy Levels
- Occupants 17y and older
- Occupants 16y and under
- Pets
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Quantity 17y and over
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Comments
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Quantity 16y and under
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Comments
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Quantity of pets
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Comments
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Age Banding Of Property
- A - (Pre 1900)
- B - (1900-1929)
- C - (1930-1949)
- D - (1950-1966)
- E - (1967-1975)
- F - (1976-1982)
- G - (1983-1990)
- H - (1991-1995)
- I - (1996-2002)
- J - (2003-2006)
- K - (2007-Onwards)
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Current SAP Rating and Band
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Image of EPC
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Year EPC Undertaken
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Fuel Type
- Electric
- Gas
- Solid fuel
- LPG
- Oil
- Other
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Comments
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Comments
Information From The Resident
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Is Resident Information required for this project ?
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Does the Property have wi-fi enabled and suitable for monitoring/management system to be connected
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Would the resident give permission to install the monitoring equipment ?
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What is your opinion regarding your current fuel bills
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Comments
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Has there been any recent works carried out to your property, which may effect you fuel bills ?
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Details
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When is your Property occupied ?
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How do you currently pay your fuel bills ?
- Gas - Pre Payment
- Gas - Monthly
- Gas - Quarterly
- Electric - Pre Payment
- Electric- Monthly
- Electric - Quarterly
- Other Fuel
- Dual - Pre Payment
- Dual - Monthly
- Dual - Quarterly
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Details
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Are There Any Specific Circumstances That Affect Your Fuel Bills ?
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Comments
Electric
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How much do you currently pay for Electric ?
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What Is The Annual Electric Usage?
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Payment Evidence
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Add media
Gas
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Does The Property Have A Gas Supply ?
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How much do you currently paid for Gas ?
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What Is The Annual Gas Usage?
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Payment Evidence
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Add media
Other Fuel Types
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Does The Property Have An Alternative Fuel Supply ?
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What Alternative Fuel is Present ?
- Coal
- Logs
- Biomass
- LPG
- Oil
- Other
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How much do you currently pay ?
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What Is The Annual Usage?
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Payment Evidence
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Add media
Recommendations
Wall Insulation
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Is wall Insulation recommended ?
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What wall insulation measures are recommended
- Cavity Wall Insulation
- External Wall Insulation
- Internal Wall Insulation
- Cavity Wall Extraction
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Comments
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Comments
Ventilation
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Is Ventilation Recommended?
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Comments
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Comments
Loft Insulation
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Is a Loft Insulation Recommended ?
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Comments
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Comments
Heating
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Is The Property Suitable For a Heating Upgrade
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What Heating System Is Recommended ?
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Comments
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Comments
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Do The Heating Controls Require Upgrading ?
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What Heating Controls Are Recommended ?
- Programmer
- Room Stat
- TRV’s
- Programmable Room Stat
- Other
- To Compliment Heating System
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Comments
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Comments
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Does The Cylinder Insulation Require Upgrading ?
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Comments
Solar PV
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Is The Property Suitable For PV
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Comments
Fuel Switching
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Is The Property Suitable For Fuel Switching
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Comments
Quick wins
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Is low energy lighting recommended ?
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Comments
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Are full SAP calculations recommended ?
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Comments
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Is a new EPC recommended ?
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Reason And Timing For EPC
- No Current EPC
- Update EPC
- New EPC After Recommendations
- Other
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EPC Comments
Survey Sign Off
Survey Sign off
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Low Carbon Exchange
