F221 LCX Energy Efficiency Survey V.1.0

• Input Property Address

• Audit Title

  Select F221 LCX Energy Efficiency Survey

  • F221 LCX Energy Efficiency Survey

General Details

• Survey Completed By

  Select Steve Britton Lee Glenister Rob McKenna Nick Phillips Sean Glossop Jez Illy Vinnie Stokes Billy Wright Other (state who)

  • Steve Britton
  • Lee Glenister
  • Rob McKenna
  • Nick Phillips
  • Sean Glossop
  • Jez Illy
  • Vinnie Stokes
  • Billy Wright
  • Other (state who)

• Client

  Select Shal Housing Stroud Borough Council Abri Exeter City Council North Devon Housing Selwood Dartford BC Brighter Places LIVE WEST Other

  • Shal Housing
  • Stroud Borough Council
  • Abri
  • Exeter City Council
  • North Devon Housing
  • Selwood
  • Dartford BC
  • Brighter Places
  • LIVE WEST
  • Other

• Resident Name

• Phone Number

• Second Phone Number

• Email Address

• Site Address
  Address

• Photo of property (Full front elevation)

  Media

• Date of Survey

  Date

• Has a Covid19 Risk Assessment been conducted ?

  Yes

  No

  N/A

Property Details

• Property Type

  Select House Bungalow Flat Maisonette Commercial Other

  • House
  • Bungalow
  • Flat
  • Maisonette
  • Commercial
  • Other

• Comments

• Property Attachment

  Select Semi Detached Detached Mid Terraced End Terraced Ground Floor Flat Mid Floor Flat Top Floor Flat Other

  • Semi Detached
  • Detached
  • Mid Terraced
  • End Terraced
  • Ground Floor Flat
  • Mid Floor Flat
  • Top Floor Flat
  • Other

• Description of Other

• What is the Overall wall thickness (mm) ?

• Number of Bedrooms

• Select Occupancy Levels

  Select Occupants 17y and older Occupants 16y and under Pets

  • Occupants 17y and older
  • Occupants 16y and under
  • Pets

• Quantity 17y and over

• Comments

• Quantity 16y and under

• Comments

• Quantity of pets

• Comments

• Age Banding Of Property

  Select 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 - (2007-2011) L - (2012 - onwards)

  • 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 - (2007-2011)
  • L - (2012 - onwards)

• Current SAP Rating and Band

• Year EPC Undertaken

• Fuel Type

  Select Electric Gas Solid fuel LPG Oil Other

  • Electric
  • Gas
  • Solid fuel
  • LPG
  • Oil
  • Other

• Comments

External Property Construction

• What Is The General Construction Type

  Select Cavity Narrow Cavity <38mm Solid Wall System Build Timber Frame Other

  • Cavity
  • Narrow Cavity <38mm
  • Solid Wall
  • System Build
  • Timber Frame
  • Other

• What is the Cavity width (mm) ?

• Photos of Cavity Width

  Media

• Boroscope Photos

  Media

• Which Elevations exist on this property

  Select Front Rear Left Side (looking from front) Right Side (looking from front) Extensions or Additions

  • Front
  • Rear
  • Left Side (looking from front)
  • Right Side (looking from front)
  • Extensions or Additions

• Front Elevation photos

  Media

• Sketch or Photo of Elevation (with dimensions)

  Media

• Comments

• What is the Front elevation construction ?

  Select Cavity Narrow Cavity <38mm Solid Wall System Build Timber Frame Other

  • Cavity
  • Narrow Cavity <38mm
  • Solid Wall
  • System Build
  • Timber Frame
  • Other

• What is the Cavity width (mm) ?

• Photos of Cavity Width

  Media

• Boroscope Photos

  Media

• Comments on alternative wall construction

• Is a DPC present and visible ?

  Select Bitumen free polymeric Slate Asphalt Plastic Membrane Injected Chemical No DPC Visible

  • Bitumen free polymeric
  • Slate
  • Asphalt
  • Plastic Membrane
  • Injected Chemical
  • No DPC Visible

• Is there any visual damage to the DPC ?

  YES

  NO

  N/A

• Comments of damaged DPC

• Photo of Damaged DPC

  Media

• Is the DPC 150mm or more above ground level

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photo of DPC level including tape measure

  Media

• Photo of DPC level including tape measure

  Media

• What is the minimum height of the DPC above ground level

• Are there any extenuating circumstances (eg: hard surface running away from elevation)

  Yes

  No

  N/A

• What solution is recommended ?

  Select Excavate ground level Excavate and install french drain Excavate and install ACO drain Other

  • Excavate ground level
  • Excavate and install french drain
  • Excavate and install ACO drain
  • Other

• What are the measurements ?

• What are the measurements ?

• What works are required ?

• What are the measurements ?

• Visual Condition of the elevation

  Very Good

  Good

  Satisfactory

  Poor

• Explanation of poor elevation condition

  Select Hairline Cracking Horizontal Cracking Cracking around openings Diagonal Cracking Mortar Joints Damaged / Missing Bricks Damaged / Missing Render Porous Wall Material Paint Condition Other

  • Hairline Cracking
  • Horizontal Cracking
  • Cracking around openings
  • Diagonal Cracking
  • Mortar Joints
  • Damaged / Missing Bricks
  • Damaged / Missing Render
  • Porous Wall Material
  • Paint Condition
  • Other

• Photos of Cracking

  Media

• Linear Meterage of cracking

• Photos of Mortar

  Media

• Square Meterage of re-pointing

• Photos of Missing Bricks

  Media

• Quantity of bricks required

• Photos of Damaged Render

  Media

• Square Meterage of Render Required

• Photos of Wall

  Media

• Square Meterage of Sealant Required

• Photos of Paint

  Media

• Square Meterage of Paint required

• Colour of Paint Required

• Photos

  Media

• Comments

• What is External Wall Material

  Select Brick Painted Render Pebble/Spar Dash Natural Stone Reconstructed Stone Upvc Cladding Timber Cladding Hanging Wall Tile or Slate External Wall Insulation Tyrolean System Built Other

  • Brick
  • Painted Render
  • Pebble/Spar Dash
  • Natural Stone
  • Reconstructed Stone
  • Upvc Cladding
  • Timber Cladding
  • Hanging Wall Tile or Slate
  • External Wall Insulation
  • Tyrolean
  • System Built
  • Other

• Comments

• Photo

• What Is The External Wall Thickness (mm) ?

• Rear Elevation Photos

  Media

• Sketch or Photo of rear elevation (with dimensions)

  Media

• Comments

• What is the rear elevation construction ?

  Select Cavity Narrow Cavity <38mm Solid Wall System Build Timber Frame Other

  • Cavity
  • Narrow Cavity <38mm
  • Solid Wall
  • System Build
  • Timber Frame
  • Other

• What is the Cavity width (mm) ?

• Photos of Cavity Width

  Media

• Boroscope Photos

  Media

• Comments on alternative wall construction

• Is a DPC present and visible ?

  Select Bitumen free polymeric Slate Asphalt Plastic Membrane Injected Chemical No DPC Visible

  • Bitumen free polymeric
  • Slate
  • Asphalt
  • Plastic Membrane
  • Injected Chemical
  • No DPC Visible

• Is there any visual damage to the DPC ?

  YES

  NO

  N/A

• Comments of damaged DPC

• Photo of Damaged DPC

  Media

• Is the DPC 150mm or more above ground level

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photo of DPC level including tape measure

  Media

• Photo of DPC level including tape measure

  Media

• What is the minimum height of the DPC above ground level

• Are there any extenuating circumstances (eg: hard surface running away from elevation)

  Yes

  No

  N/A

• What solution is recommended ?

  Select Excavate ground level Excavate and install french drain Excavate and install ACO drain Other

  • Excavate ground level
  • Excavate and install french drain
  • Excavate and install ACO drain
  • Other

• What are the measurements ?

• What are the measurements ?

• What works are required ?

• What are the measurements ?

• Visual Condition of the elevation

  Very Good

  Good

  Satisfactory

  Poor

• Explanation of poor elevation condition

  Select Hairline Cracking Horizontal Cracking Cracking around openings Diagonal Cracking Mortar Joints Damaged / Missing Bricks Damaged / Missing Render Porous Wall Material Paint Condition Other

  • Hairline Cracking
  • Horizontal Cracking
  • Cracking around openings
  • Diagonal Cracking
  • Mortar Joints
  • Damaged / Missing Bricks
  • Damaged / Missing Render
  • Porous Wall Material
  • Paint Condition
  • Other

• Photos of Cracking

  Media

• Linear Meterage of cracking

• Photos of Mortar

  Media

• Square Meterage of re-pointing

• Photos of Missing Bricks

  Media

• Quantity of bricks required

• Photos of Damaged Render

  Media

• Square Meterage of Render Required

• Photos of Wall

  Media

• Square Meterage of Sealant Required

• Photos of Paint

  Media

• Square Meterage of Paint required

• Colour of Paint Required

• Photos

  Media

• Comments

• What is External Wall Material

  Select Brick Painted Render Pebble/Spar Dash Natural Stone Reconstructed Stone Upvc Cladding Timber Cladding Hanging Wall Tile or Slate External Wall Insulation Tyrolean System Built Other

  • Brick
  • Painted Render
  • Pebble/Spar Dash
  • Natural Stone
  • Reconstructed Stone
  • Upvc Cladding
  • Timber Cladding
  • Hanging Wall Tile or Slate
  • External Wall Insulation
  • Tyrolean
  • System Built
  • Other

• Comments

• Photo

• What Is The External Wall Thickness (mm) ?

• Left side (looking at the property) photos

  Media

• Sketch or Photo of left side (with dimensions)

  Media

• Comments

• What is the left side elevation construction ?

  Select Cavity Narrow Cavity <38mm Solid Wall System Build Timber Frame Other

  • Cavity
  • Narrow Cavity <38mm
  • Solid Wall
  • System Build
  • Timber Frame
  • Other

• Comments on alternative wall construction

• Is a DPC present and visible ?

  Select Bitumen free polymeric Slate Asphalt Plastic Membrane Injected Chemical No DPC Visible

  • Bitumen free polymeric
  • Slate
  • Asphalt
  • Plastic Membrane
  • Injected Chemical
  • No DPC Visible

• Is there any visual damage to the DPC ?

  YES

  NO

  N/A

• Comments of damaged DPC

• Photo of Damaged DPC

  Media

• Is the DPC 150mm or more above ground level

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photo of DPC level including tape measure

  Media

• Photo of DPC level including tape measure

  Media

• What is the minimum height of the DPC above ground level

• Are there any extenuating circumstances (eg: hard surface running away from elevation)

  Yes

  No

  N/A

• What solution is recommended ?

  Select Excavate ground level Excavate and install french drain Excavate and install ACO drain Other

  • Excavate ground level
  • Excavate and install french drain
  • Excavate and install ACO drain
  • Other

• What are the measurements ?

• What are the measurements ?

• What works are required ?

• What are the measurements ?

• Visual Condition of the elevation

  Very Good

  Good

  Satisfactory

  Poor

• Explanation of poor elevation condition

  Select Hairline Cracking Horizontal Cracking Cracking around openings Diagonal Cracking Mortar Joints Damaged / Missing Bricks Damaged / Missing Render Porous Wall Material Paint Condition Other

  • Hairline Cracking
  • Horizontal Cracking
  • Cracking around openings
  • Diagonal Cracking
  • Mortar Joints
  • Damaged / Missing Bricks
  • Damaged / Missing Render
  • Porous Wall Material
  • Paint Condition
  • Other

• Photos of Cracking

  Media

• Linear Meterage of cracking

• Photos of Mortar

  Media

• Square Meterage of re-pointing

• Photos of Missing Bricks

  Media

• Quantity of bricks required

• Photos of Damaged Render

  Media

• Square Meterage of Render Required

• Photos of Wall

  Media

• Square Meterage of Sealant Required

• Photos of Paint

  Media

• Square Meterage of Paint required

• Colour of Paint Required

• Photos

  Media

• Comments

• What is External Wall Material

  Select Brick Painted Render Pebble/Spar Dash Natural Stone Reconstructed Stone Upvc Cladding Timber Cladding Hanging Wall Tile or Slate External Wall Insulation Tyrolean System Built Other

  • Brick
  • Painted Render
  • Pebble/Spar Dash
  • Natural Stone
  • Reconstructed Stone
  • Upvc Cladding
  • Timber Cladding
  • Hanging Wall Tile or Slate
  • External Wall Insulation
  • Tyrolean
  • System Built
  • Other

• Comments

• Photo

• What Is The External Wall Thickness (mm) ?

• Right side (looking at the property) photos

  Media

• Sketch or Photo of right side (with dimensions)

  Media

• Comments

• What is the right side elevation construction ?

  Select Cavity Narrow Cavity <38mm Solid Wall System Build Timber Frame Other

  • Cavity
  • Narrow Cavity <38mm
  • Solid Wall
  • System Build
  • Timber Frame
  • Other

• What is the Cavity width (mm) ?

• Photos of Cavity Width

  Media

• Boroscope Photos

  Media

• Comments on alternative wall construction

• Is a DPC present and visible ?

  Select Bitumen free polymeric Slate Asphalt Plastic Membrane Injected Chemical No DPC Visible

  • Bitumen free polymeric
  • Slate
  • Asphalt
  • Plastic Membrane
  • Injected Chemical
  • No DPC Visible

• Is there any visual damage to the DPC ?

  YES

  NO

  N/A

• Comments of damaged DPC

• Photo of Damaged DPC

  Media

• Is the DPC 150mm or more above ground level

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photo of DPC level including tape measure

  Media

• Photo of DPC level including tape measure

  Media

• What is the minimum height of the DPC above ground level

• Are there any extenuating circumstances (eg: hard surface running away from elevation)

  Yes

  No

  N/A

• What solution is recommended ?

  Select Excavate ground level Excavate and install french drain Excavate and install ACO drain Other

  • Excavate ground level
  • Excavate and install french drain
  • Excavate and install ACO drain
  • Other

• What are the measurements ?

• What are the measurements ?

• What works are required ?

• What are the measurements ?

• Visual Condition of the elevation

  Very Good

  Good

  Satisfactory

  Poor

• Explanation of poor elevation condition

  Select Hairline Cracking Horizontal Cracking Cracking around openings Diagonal Cracking Mortar Joints Damaged / Missing Bricks Damaged / Missing Render Porous Wall Material Paint Condition Other

  • Hairline Cracking
  • Horizontal Cracking
  • Cracking around openings
  • Diagonal Cracking
  • Mortar Joints
  • Damaged / Missing Bricks
  • Damaged / Missing Render
  • Porous Wall Material
  • Paint Condition
  • Other

• Photos of Cracking

  Media

• Linear Meterage of cracking

• Photos of Mortar

  Media

• Square Meterage of re-pointing

• Photos of Missing Bricks

  Media

• Quantity of bricks required

• Photos of Damaged Render

  Media

• Square Meterage of Render Required

• Photos of Wall

  Media

• Square Meterage of Sealant Required

• Photos of Paint

  Media

• Square Meterage of Paint required

• Colour of Paint Required

• Photos

  Media

• Comments

• What is External Wall Material

  Select Brick Painted Render Pebble/Spar Dash Natural Stone Reconstructed Stone Upvc Cladding Timber Cladding Hanging Wall Tile or Slate External Wall Insulation Tyrolean System Built Other

  • Brick
  • Painted Render
  • Pebble/Spar Dash
  • Natural Stone
  • Reconstructed Stone
  • Upvc Cladding
  • Timber Cladding
  • Hanging Wall Tile or Slate
  • External Wall Insulation
  • Tyrolean
  • System Built
  • Other

• Comments

• Photo

• What Is The External Wall Thickness (mm) ?

• Extensions or addition elevation photos

  Media

• Sketch or Photo of Elevation (with dimensions)

  Media

• Comments

• What is the extensions or additions elevation construction ?

  Select Cavity Narrow Cavity <38mm Solid Wall System Build Timber Frame Other

  • Cavity
  • Narrow Cavity <38mm
  • Solid Wall
  • System Build
  • Timber Frame
  • Other

• What is the Cavity width (mm) ?

• Photos of Cavity Width

  Media

• Boroscope Photos

  Media

• Comments on alternative wall construction

• Is a DPC present and visible ?

  Select Bitumen free polymeric Slate Asphalt Plastic Membrane Injected Chemical No DPC Visible

  • Bitumen free polymeric
  • Slate
  • Asphalt
  • Plastic Membrane
  • Injected Chemical
  • No DPC Visible

• Is there any visual damage to the DPC ?

  YES

  NO

  N/A

• Comments of damaged DPC

• Photo of Damaged DPC

  Media

• Is the DPC 150mm or more above ground level

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photo of DPC level including tape measure

  Media

• Photo of DPC level including tape measure

  Media

• What is the minimum height of the DPC above ground level

• Are there any extenuating circumstances (eg: hard surface running away from elevation)

  Yes

  No

  N/A

• What solution is recommended ?

  Select Excavate ground level Excavate and install french drain Excavate and install ACO drain Other

  • Excavate ground level
  • Excavate and install french drain
  • Excavate and install ACO drain
  • Other

• What are the measurements ?

• What are the measurements ?

• What works are required ?

• What are the measurements ?

• Visual Condition of the elevation

  Very Good

  Good

  Satisfactory

  Poor

• Explanation of poor elevation condition

  Select Hairline Cracking Horizontal Cracking Cracking around openings Diagonal Cracking Mortar Joints Damaged / Missing Bricks Damaged / Missing Render Porous Wall Material Paint Condition Other

  • Hairline Cracking
  • Horizontal Cracking
  • Cracking around openings
  • Diagonal Cracking
  • Mortar Joints
  • Damaged / Missing Bricks
  • Damaged / Missing Render
  • Porous Wall Material
  • Paint Condition
  • Other

• Photos of Cracking

  Media

• Linear Meterage of cracking

• Photos of Mortar

  Media

• Square Meterage of re-pointing

• Photos of Missing Bricks

  Media

• Quantity of bricks required

• Photos of Damaged Render

  Media

• Square Meterage of Render Required

• Photos of Wall

  Media

• Square Meterage of Sealant Required

• Photos of Paint

  Media

• Square Meterage of Paint required

• Colour of Paint Required

• Photos

  Media

• Comments

• What is External Wall Material

  Select Brick Painted Render Pebble/Spar Dash Natural Stone Reconstructed Stone Upvc Cladding Timber Cladding Hanging Wall Tile or Slate External Wall Insulation Tyrolean System Built Other

  • Brick
  • Painted Render
  • Pebble/Spar Dash
  • Natural Stone
  • Reconstructed Stone
  • Upvc Cladding
  • Timber Cladding
  • Hanging Wall Tile or Slate
  • External Wall Insulation
  • Tyrolean
  • System Built
  • Other

• Comments

• Photo

• What Is The External Wall Thickness (mm) ?

Roof

• Photo of Roof

  Media

• What is the roof covering ?

  Select Concrete Tile Clay Tile Artificial Slate Natural Slate Felt Fiberglass Other N/A (eg ground floor flat)

  • Concrete Tile
  • Clay Tile
  • Artificial Slate
  • Natural Slate
  • Felt
  • Fiberglass
  • Other
  • N/A (eg ground floor flat)

• What is the condition of the roof covering ?

  Select Very Good Good Satisfactory Poor

  • Very Good
  • Good
  • Satisfactory
  • Poor

• Explanation of poor condition

• Photo of poor roof condition

  Media

• Description of other roof covering

• Photo of other roof covering

  Media

• What are the tile features ?

  Select Ridge Hip Verge Valley Abutment Mono Ridge Other

  • Ridge
  • Hip
  • Verge
  • Valley
  • Abutment
  • Mono Ridge
  • Other

• What is the condition of the hip ?

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Description of poor condition

  Select Tiles missing Tiles loose Mortar missing Mortar Cracked Leadwork Damaged Leadwork missing Hip iron missing

  • Tiles missing
  • Tiles loose
  • Mortar missing
  • Mortar Cracked
  • Leadwork Damaged
  • Leadwork missing
  • Hip iron missing

• Photo of poor condition

  Media

• What is the condition of the verge ?

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Description of poor condition

  Select Tiles missing Tiles loose Mortar missing Mortar Cracked Leadwork Damaged Leadwork missing Hip iron missing

  • Tiles missing
  • Tiles loose
  • Mortar missing
  • Mortar Cracked
  • Leadwork Damaged
  • Leadwork missing
  • Hip iron missing

• Photo of poor condition

  Media

• What is the condition of the valley ?

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Description of poor condition

  Select Tiles missing Tiles loose Mortar missing Mortar Cracked Leadwork Damaged Leadwork missing Hip iron missing

  • Tiles missing
  • Tiles loose
  • Mortar missing
  • Mortar Cracked
  • Leadwork Damaged
  • Leadwork missing
  • Hip iron missing

• Photo of poor condition

  Media

• What is the condition of the abutment ?

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Description of poor condition

  Select Tiles missing Tiles loose Mortar missing Mortar Cracked Leadwork Damaged Leadwork missing Hip iron missing

  • Tiles missing
  • Tiles loose
  • Mortar missing
  • Mortar Cracked
  • Leadwork Damaged
  • Leadwork missing
  • Hip iron missing

• Photo of poor condition

  Media

• Description of other roof features

• What is the condition of the other roof feature ?

  Good

  Fair

  Poor

  N/A

• Description of poor condition

  Select Tiles missing Tiles loose Mortar missing Mortar Cracked Leadwork Damaged Leadwork missing Hip iron missing

  • Tiles missing
  • Tiles loose
  • Mortar missing
  • Mortar Cracked
  • Leadwork Damaged
  • Leadwork missing
  • Hip iron missing

• General photo of poor condition

  Media

• What is the condition of the mono ridge ?

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Description of poor condition

  Select Tiles missing Tiles loose Mortar missing Mortar Cracked Leadwork Damaged Leadwork missing Hip iron missing

  • Tiles missing
  • Tiles loose
  • Mortar missing
  • Mortar Cracked
  • Leadwork Damaged
  • Leadwork missing
  • Hip iron missing

• Photo of poor condition

  Media

• Is there any roof ventilation ?

  Yes

  No

  N/A

• Photo of roof ventilation

  Media

• Description of ventilation

  Media

External Joinery

• Window material type

  Select uPVC Timber Aluminium Steel Other

  • uPVC
  • Timber
  • Aluminium
  • Steel
  • Other

• General condition of windows

  Good

  Fair

  Poor

  N/A

• Explanation of poor window condition

  Select Broken down sealed units Damaged/missing draft proofing Broken glass Damaged window furniture Poor window sealant Blocked opening Other

  • Broken down sealed units
  • Damaged/missing draft proofing
  • Broken glass
  • Damaged window furniture
  • Poor window sealant
  • Blocked opening
  • Other

• Photos of poor window condition

  Media

• Photos of windows

  Media

• What type of glazing is present

  Select Single Glazed Double Glazed Triple Glazed

  • Single Glazed
  • Double Glazed
  • Triple Glazed

• What are the percentages of glazing type

• What is the age of the windows ?

  Select Pre 2002 2002 onwards Unable to determine

  • Pre 2002
  • 2002 onwards
  • Unable to determine

• What is the glazing gap ?

  Select 6mm 12mm 16mm (or more)

  • 6mm
  • 12mm
  • 16mm (or more)

• What external doors are present

  Select Front door Rear door Side door Shed/Outhouse Communal door to flats

  • Front door
  • Rear door
  • Side door
  • Shed/Outhouse
  • Communal door to flats

• Front door material type

  Select uPVC Timber Composite Steel Aluminium Insulated door with known U-Value

  • uPVC
  • Timber
  • Composite
  • Steel
  • Aluminium
  • Insulated door with known U-Value

• General condition of external front door

  Good

  Fair

  Poor

  N/A

• Explanation of poor external front door condition

  Select Broken down sealed units Damaged/missing draft proofing Broken glass Damaged window furniture Poor window sealant Blocked opening Other

  • Broken down sealed units
  • Damaged/missing draft proofing
  • Broken glass
  • Damaged window furniture
  • Poor window sealant
  • Blocked opening
  • Other

• Photos of poor external front door condition

  Media

• Photos of external doors

  Media

• Is the front door glazed ?

  Yes

  No

  Unsure

• What glazing is present on the front door ?

  Single Glazed

  Double Glazed

  Triple Glazed

• Rear door material type

  Select uPVC Timber Composite Steel Aluminium Insulated door with known U-Value

  • uPVC
  • Timber
  • Composite
  • Steel
  • Aluminium
  • Insulated door with known U-Value

• General condition of external rear door

  Good

  Fair

  Poor

  N/A

• Explanation of poor external rear door condition

  Select Broken down sealed units Damaged/missing draft proofing Broken glass Damaged window furniture Poor window sealant Blocked opening Other

  • Broken down sealed units
  • Damaged/missing draft proofing
  • Broken glass
  • Damaged window furniture
  • Poor window sealant
  • Blocked opening
  • Other

• Photos of poor external rear door condition

  Media

• Photos of external doors

  Media

• Is the rear door glazed ?

  Yes

  No

  Unsure

• What glazing is present on the rear door ?

  Single Glazed

  Double Glazed

  Triple Glazed

• Side door material type

  Select uPVC Timber Composite Steel Aluminium Insulated door with known U-Value

  • uPVC
  • Timber
  • Composite
  • Steel
  • Aluminium
  • Insulated door with known U-Value

• General condition of external side door

  Good

  Fair

  Poor

  N/A

• Explanation of poor external side door condition

  Select Broken down sealed units Damaged/missing draft proofing Broken glass Damaged window furniture Poor window sealant Blocked opening Other

  • Broken down sealed units
  • Damaged/missing draft proofing
  • Broken glass
  • Damaged window furniture
  • Poor window sealant
  • Blocked opening
  • Other

• Photos of poor external side door condition

  Media

• Photos of external doors

  Media

• Is the side door glazed ?

  Yes

  No

  Unsure

• What glazing is present on the side door ?

  Single Glazed

  Double Glazed

  Triple Glazed

• Shed/Outhouse door material type

  Select uPVC Timber Composite Steel Aluminium Insulated door with known U-Value

  • uPVC
  • Timber
  • Composite
  • Steel
  • Aluminium
  • Insulated door with known U-Value

• General condition of external shed/outhouse door

  Good

  Fair

  Poor

  N/A

• Explanation of poor external shed/outhouse condition

  Select Broken down sealed units Damaged/missing draft proofing Broken glass Damaged window furniture Poor window sealant Blocked opening Other

  • Broken down sealed units
  • Damaged/missing draft proofing
  • Broken glass
  • Damaged window furniture
  • Poor window sealant
  • Blocked opening
  • Other

• Photos of poor external shed/outhouse door condition

  Media

• Photos of external doors

  Media

• Is the shed/outhouse door glazed ?

  Yes

  No

  Unsure

• What glazing is present on the shed/outhouse door ?

  Single Glazed

  Double Glazed

  Triple Glazed

Internal Property Survey

• Which rooms exist in this property

  Select Kitchen Utility Hallway Living room Dining room WC Bathroom Landing Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5

  • Kitchen
  • Utility
  • Hallway
  • Living room
  • Dining room
  • WC
  • Bathroom
  • Landing
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5

• Photo of humidity meter reading in Bedroom 5

  Media

• Floor Type

  Select Solid Suspended Timber Suspended NOT Timber Unheated Space Below Another Dwelling Below Same Property Below Other

  • Solid
  • Suspended Timber
  • Suspended NOT Timber
  • Unheated Space Below
  • Another Dwelling Below
  • Same Property Below
  • Other

• Comments

• Are There Any Issues With The Building Fabric in the Bedroom 5 ?

  YES

  NO

  N/A

• What Issues are present in Bedroom 5 ?

  Select Damp Mould Condensation Cold Bridging Other

  • Damp
  • Mould
  • Condensation
  • Cold Bridging
  • Other

• Photos of issues

  Media

• Comments of issues

• Does bedroom 5 have Dry Lining ?

  Yes

  No

  Unsure

• Does this room have any ventilation

  Select Yes No Unsure

  • Yes
  • No
  • Unsure

• Photo of Ventilation

  Media

• Type of ventilation

  Select Intermittent Extractor Fan Continuous Extractor Fan Faulty Extractor Fan PIV Unit MVHR Unit Recirculating Cooker Hood Extracting Cooker Hood Air Brick Window Trickle Vents Purge Ventilation None Other

  • Intermittent Extractor Fan
  • Continuous Extractor Fan
  • Faulty Extractor Fan
  • PIV Unit
  • MVHR Unit
  • Recirculating Cooker Hood
  • Extracting Cooker Hood
  • Air Brick
  • Window Trickle Vents
  • Purge Ventilation
  • None
  • Other

• Photo of fan flow rate (in litres per second)

  Media

• What is the fan flow rate (in litres per second)

• Comments of ventilation

• What Fire/Smoke detectors are present

  Select Smoke detector Heat detector Carbon Monoxide

  • Smoke detector
  • Heat detector
  • Carbon Monoxide

• Is Smoke detector working ?

  Yes

  No

  Unsure

• Is Heat detector working ?

  Yes

  No

  Unsure

• Is Carbon Monoxide detector working ?

  Yes

  No

  Unsure

• What is the Ground Floor Construction?

  Select Solid Suspended Timber Suspended NOT Timber Unheated Space Below Another Dwelling Below Same Property Below Other

  • Solid
  • Suspended Timber
  • Suspended NOT Timber
  • Unheated Space Below
  • Another Dwelling Below
  • Same Property Below
  • Other

• Comments

• Are There Any Issues With The Building Fabric Internally?

  YES

  NO

  N/A

• Describe Issues

Heating System

• What is the main heating system ?

  Select Gas Boiler Electric Storage Heater Oil Boiler ASHP LPG Boiler Electric Boiler Solid Fuel Boiler Multi Fuel GSHP

  • Gas Boiler
  • Electric Storage Heater
  • Oil Boiler
  • ASHP
  • LPG Boiler
  • Electric Boiler
  • Solid Fuel Boiler
  • Multi Fuel
  • GSHP

• Photo of heating system

  Media

• Description of heating system (make and model)

• What are the heating system controls

  Select Programmer Room Stat TRV’s Programmable Room Stat Other To Compliment Heating System

  • Programmer
  • Room Stat
  • TRV’s
  • Programmable Room Stat
  • Other
  • To Compliment Heating System

• Details

• Is there a secondary heating system?

  Yes

  No

  Unsure

• What is the secondary heating system ?

  Select Open fire with internal chimney Wood burner Gas fire with balanced flue Gas fire with internal chimney Electric feature fire Open fire with external chimney Flush fitted gas fire Electric plugin heaters

  • Open fire with internal chimney
  • Wood burner
  • Gas fire with balanced flue
  • Gas fire with internal chimney
  • Electric feature fire
  • Open fire with external chimney
  • Flush fitted gas fire
  • Electric plugin heaters

• Photo of secondary heating

  Media

• Is there a hot water cylinder ?

  Yes

  No

  Unsure

• Photo of cylinder

  Media

• Is the cylinder insulated

  Select No Insulation Jacket Insulation Foam Insulation less then 25mm Foam Insulation 25mm thickness or more Sealed cylinder

  • No Insulation
  • Jacket Insulation
  • Foam Insulation less then 25mm
  • Foam Insulation 25mm thickness or more
  • Sealed cylinder

• Thickness of insulation

• Does the cylinder have a Thermostat ?

  Yes

  No

  Unsure

• Photo of Thermostat

  Media

• Does the cylinder have a Control unit ?

  Yes

  No

  Unsure

• Photo of control unit

  Media

Lighting

• How many fixed lights in the property (including external lighting) ?

• How many lights are low energy ?

Loft

• Is the Loft Insulated ?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• What is the insulation ?

  Select Roll Matt Blown Fibre Vermiculite Warmcel Rigid Insulation (eg celotex) Multifoil

  • Roll Matt
  • Blown Fibre
  • Vermiculite
  • Warmcel
  • Rigid Insulation (eg celotex)
  • Multifoil

• What Is The Insulation Depth (mm)

• What is the condition of the insulation ?

  Select Good Fair Poor N/A

  • Good
  • Fair
  • Poor
  • N/A

• Comments of insulation condition

  Select Poorly laid Only laid in one direction Uneven Missing Blocking Eaves Short of Eaves

  • Poorly laid
  • Only laid in one direction
  • Uneven
  • Missing
  • Blocking Eaves
  • Short of Eaves

• Is the loft cluttered?

  YES

  NO

  N/A

• Photo of Clutter

  Media

• Is the loft ventilated ?

  Yes

  No

  N/A

• How is the loft ventilated ?

  Select Eaves Ventilation Vent tiles Breathable felt Gable vents Felt wedges Mechanical ventilation

  • Eaves Ventilation
  • Vent tiles
  • Breathable felt
  • Gable vents
  • Felt wedges
  • Mechanical ventilation

• Is the Loft Hatch Insulated ?

  Yes

  No

  N/A

• Photo of top of loft hatch

  Media

• Is the Loft Hatch draught proofed ?

  Yes

  No

  N/A

• Photo of underside of loft hatch

  Media

• Are there sloping ceilings ?

  YES

  NO

  N/A

• Are sloping ceilings correctly insulated ?

  Yes

  No

  Unsure

• Photos

  Media

• Is there any ducting in the loft

  YES

  NO

  N/A

• Photos of ducting

  Media

• Comments of ducting

Information From The Resident

• Is Resident Information required for this project ?

  Yes

  No

  N/A

• What is your opinion regarding your current fuel bills

  High

  Fair

  Low

• Comments

• Has there been any recent works carried out to your property, which may affect you fuel bills ?

  Yes

  No

  Unsure

• Details

• When is your Property occupied ?

  Home all day

  Nobody home during the day

  Variable / shift patten

  Only Home at Weekends

• How do you currently pay your fuel bills ?

  Select Gas - Pre Payment Gas - Monthly Gas - Quarterly Electric - Pre Payment Electric- Monthly Electric - Quarterly Other Fuel Dual - Pre Payment Dual - Monthly Dual - Quarterly

  • Gas - Pre Payment
  • Gas - Monthly
  • Gas - Quarterly
  • Electric - Pre Payment
  • Electric- Monthly
  • Electric - Quarterly
  • Other Fuel
  • Dual - Pre Payment
  • Dual - Monthly
  • Dual - Quarterly

• Details

• Are There Any Specific Circumstances That Affect Your Fuel Bills ?

  Yes

  No

  Unsure

• Comments

Electric

• How much do you currently pay for Electric ?

• What Is The Annual Electric Usage?

• Payment Evidence

  Verbally

  Monthly Statement

  Quarterly Statement

  Annual Statement

  Other

• undefined

• Add media

  Media

Gas

• Does The Property Have A Gas Supply ?

  Yes

  No

  Unsure

• How much do you currently paid for Gas ?

• What Is The Annual Gas Usage?

• Payment Evidence

  Verbally

  Monthly Statement

  Quarterly Statement

  Annual Statement

  Other

• undefined

• Add media

  Media

Other Fuel Types

• Does The Property Have An Alternative Fuel Supply ?

  Yes

  No

  Unsure

• What Alternative Fuel is Present ?

  Select Coal Logs Biomass LPG Oil Other

  • Coal
  • Logs
  • Biomass
  • LPG
  • Oil
  • Other

• How much do you currently pay ?

• What Is The Annual Usage?

• Payment Evidence

  Verbally

  Monthly Statement

  Quarterly Statement

  Annual Statement

  Other

• undefined

• Add media

  Media

Recommendations

Building Works Recommended

• Are ground works required ?

  YES

  NO

  N/A

• Select required ground works

  Select Reduce level dig French drain ACO drain Soakaway Other

  • Reduce level dig
  • French drain
  • ACO drain
  • Soakaway
  • Other

• Description & quantity of reduce level dig

• Description & quantity of french drain

• Description & quantity of ACO drain

• Description & quantity of soakaway

• Description & quantity of other

• Are building works required to the walls ?

  YES

  NO

  N/A

• Is Scaffolding required ?

  YES

  NO

  N/A

• Details of required scaffold

• Select required building works

  Select Repoint (full property) Repoint (isolated areas) Crack repairs Spalled or damaged bricks Apply Weathershield Rendered plinth detail Render Repairs Other

  • Repoint (full property)
  • Repoint (isolated areas)
  • Crack repairs
  • Spalled or damaged bricks
  • Apply Weathershield
  • Rendered plinth detail
  • Render Repairs
  • Other

• Description & quantity of full property repointing

• Description & quantity of isolated area repointing

• Description & quantity of crack repairs

• Description & quantity of spalled or damaged brickwork

• Description & quantity of weathershield sealant

• Description & quantity of rendered plinth detail

• Description & quantity of render repairs

• Description & quantity of other building works required

  Select Kitchen Utility Hallway Living room Dining room WC Bathroom Landing Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5

  • Kitchen
  • Utility
  • Hallway
  • Living room
  • Dining room
  • WC
  • Bathroom
  • Landing
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5

• Are roofing works required

  YES

  NO

  N/A

• Is Scaffolding required ?

  YES

  NO

  N/A

• Details of required scaffold

• Select required roofing works

  Extend Verge (gable ladder)

  Extend Eaves

  New Soffit Details

  Other

  Insulate Sloping Ceilings

Wall Insulation Recommended

• Is wall Insulation recommended ?

  YES

  NO

  N/A

• What wall insulation measures are recommended

  Select Cavity Wall Insulation External Wall Insulation Internal Wall Insulation Cavity Wall Extraction

  • Cavity Wall Insulation
  • External Wall Insulation
  • Internal Wall Insulation
  • Cavity Wall Extraction

• m2 of area to be extracted

• Is any cavity debris or rubble apparent ?

  YES

  NO

  N/A

• Description

• Is a full PAS2035 EWI survey required ?

  YES

  NO

  N/A

• Is a full PAS2035 EWI survey required ?

  YES

  NO

  N/A

• m2 of area to be filled

• Is Scaffolding required ?

  YES

  NO

  N/A

• Details of required scaffold

• Is any cavity debris or rubble apparent ?

  YES

  NO

  N/A

• Description

Ventilation Recommended

• Is Ventilation Recommended?

  YES

  NO

  N/A

• What Measures Are Recommended ?

  Select Install New Kitchen Extract Fan Replace Existing Kitchen Extract Fan Install New Bathroom Extract Fan Replace Bathroom Extract Fan Insulated Ducting Window Trickle Vents Window Locking Night Vents Passive Whole House System Active Whole House System Other

  • Install New Kitchen Extract Fan
  • Replace Existing Kitchen Extract Fan
  • Install New Bathroom Extract Fan
  • Replace Bathroom Extract Fan
  • Insulated Ducting
  • Window Trickle Vents
  • Window Locking Night Vents
  • Passive Whole House System
  • Active Whole House System
  • Other

• Description

• Description

Loft Recommendations

• Are any works recommended in the loft ?

  YES

  NO

  N/A

• What works are recommended ?

  Select Loft Insulation Loft Ventilation Lagging Other

  • Loft Insulation
  • Loft Ventilation
  • Lagging
  • Other

• Description

  Select Remove existing insulation Tidy up existing insulation Remove tenants effects and dispose Remove and store tenants effects Top up loft insulation Extend loft insulation into eaves

  • Remove existing insulation
  • Tidy up existing insulation
  • Remove tenants effects and dispose
  • Remove and store tenants effects
  • Top up loft insulation
  • Extend loft insulation into eaves

• M2 of insulation to be removed

• Estimated time to tidy existing insulation

• Estimated time and disposal cost to remove tenants effects

• Estimated time to remove and cost to store tenants effects

• M2 and depth of insulation to be installed

• lm of loft insulation into eaves

• Description

  Install felt wedges

  Install tile vents

  Other

• Qty of wedges

• Qty of tile vents

• Comments and Qty

• Description and qty of lagging required

• Description and qty of other

Heating

• Is The Property Suitable For a Heating Upgrade

  YES

  NO

  N/A

• What Heating System Is Recommended ?

  Install Quantum heating

  Install Heat pump

  Renew Gas Boiler

  Other

• Comments

• Do The Heating Controls Require Upgrading ?

  YES

  NO

  N/A

• What Heating Controls Are Recommended ?

  Select Programmer Room Stat TRV’s Programmable Room Stat Other To Compliment Heating System

  • Programmer
  • Room Stat
  • TRV’s
  • Programmable Room Stat
  • Other
  • To Compliment Heating System

• Comments

• Does The Cylinder Insulation Require Upgrading ?

  YES

  NO

  N/A

• Comments

Solar PV

• Is The Property Suitable For PV

  YES

  NO

  N/A

• Comments

Other Recommendations

• Is low energy lighting recommended ?

  YES

  NO

  N/A

• Comments

• Are full SAP calculations recommended ?

  YES

  NO

  N/A

• Comments

• Is a new EPC recommended ?

  YES

  NO

  N/A

• Reason And Timing For EPC

  Select No Current EPC Update EPC New EPC After Recommendations Other

  • No Current EPC
  • Update EPC
  • New EPC After Recommendations
  • Other

• EPC Comments

• Summary of Findings

Survey Sign off

• Low Carbon Exchange

  Sign