Information
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Location.
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First line of the Address.
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Type of survey
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Client Name.
- Alliance Homes
- Abri
- Curo
- Cornwall
- Exeter CC
- Homes in Sedgemoor
- Ian Williams Ltd
- North Devon Homes
- PCH
- Livewest
- Sovereign
- Westwood Housing
- WHS Ltd
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Tenants or Home owners name.
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Contact Details.
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Tenure.
- Owner occupier
- Local Authority
- Housing Association
- Privately Rented
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Survey conducted by.
- Vinnie Stokes
- Sean Glossop
- Rob Mckenna
- Alister Paisley
- Ricky Whale
- Simon Farley
- Chris McColl
- Lee Glenister
- Steve Britton
- Nick Hyett
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Type of Survey
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Property Type.
- Mid-Terrace
- End terrace
- Semi-detached
- Detached
- Ground Floor Flat
- Middle Floor Flat
- Top Floor Flat
- Masonette
- Bungalow
- House
- Commercial Building
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Construction age of the building.
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Floor Construction Type
- Solid
- Suspended
- Suspended not wood
- Block and beam
- Other
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Number of Bedrooms.
- 1
- 2
- 3
- 4
- 5+
- N/A Commercial
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Heating Type?
- Mains Gas
- Oil
- Solid Fuel
- Electric
- Renewable Energy
- LPG
- Heating no working at the time of survey
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Please take photo of main heating type.
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Secondary Heat source.
- Gas Fire with Flue
- Gas Fire with chimney
- Gas Fire Flush Fitted
- Open Fire with internal chimney
- Open Fire with external chimney
- Wood Burner
- No other heating present
Property details
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Building Finish.
- Brick
- Painted Render
- Brick/Render
- Pebble Dash
- Recon Stone
- Spar
- Limestone/Sandstone
- Granite/Whinstone
- Faced brick in a high exposure area not suitable for cavity wall insulation
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Structural Condition.
- Very good
- Good
- Poor
- Very poor
- Faced brick showing damaged to brick faces and poor mortar joints
- Painted faced brick showing damaged to brick faces and poor mortar joints
- Faced brick in a high exposure area if being cavity filled we advise that the property is treated with Storm dry
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External Condition of the building.
- Very good
- Good
- Poor
- Very poor
- Faced brick showing damaged to brick faces and poor mortar joints
- Painted faced brick showing damaged to brick faces and poor mortar joints
- Faced brick in a high exposure area if being cavity filled we advise that the property is treated with Storm dry
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Remedial Works Required.
- Yes
- No
- N/A
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If yes please give details of remedial work required plus photos.
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Have you done an internal inspection of the building.
- Yes
- No
- N/A
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If you have answered yes please select the best description of your findings.
- Low level damp near the skirting boards
- Black mould in the corners of the rooms
- Black mould on the ceiling and the walls
- Condensation on the windows and external walls
- Area's of mould around the window reveals.
- Mould around the window lintels.
- Signs of moisture ingress through the external walls.
- Mould on the sloping ceilings.
- No internal issues that I can see.
- Damaged to internal plaster due to the property being faced brick and moisture ingress.
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Please take photos of your internal findings.
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Safety monitors present.
- Smoke Alarm
- Fire Alarm
- CO2 Alarm
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Have the alarms all been tested by surveyor.
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Protected species or rodents present in building.
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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
- Scaffold Board for Flat Roof
- Scaffolding
- Conservatory Ladder
- Roof Ladder
Extraction details
Details
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Total area to be extracted, cleaned or inspected.
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Material to be extracted.
- Yellow/White Fibre
- Foam
- Rockwool
- Loose polystyrene bead
- Debris / Rubble
- Over bonded bead
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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
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
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Total area to be omitted.
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Photos of omitted areas.
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Are there any mechanical ventilation fans fitted in the property?
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If yes please select which room.
- Kitchen
- Bathroom
- Utility
- W/C
- En-suite
- Cooker hood
- Positive input ventilation
- Passive ventilation (Opening window)
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Are the mechanical ventilation fans working? If so please select which rooms.(survey to run fan for a few minutes)
- Kitchen
- Bathroom
- Utility
- W/C
- En-suite
- Cooker hood
- Positive input ventilation
- Passive ventilation (Opening window)
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Does the building have any air vents.
- Yes
- No
- N/A
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If yes please select.
- Underfloor vents
- Kitchen vents
- Bedroom vents
- Bathroom vents
- Combustion vents
- Pantry vents
- Trickle vents
- No ventilation within the building
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Do any of the air vents require sleeving or sealing up before installing the cavities.
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If yes please select the air vents that require sleeving or sealing up.
- Underfloor vents
- Kitchen vents
- Bedroom vents
- Bathroom vents
- Combustion vents
- Pantry vents
- Trickle vents
- No ventilation within the building
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Adjoining properties insulated ?
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Number of Cavity brushes required.
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Core vent required.
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Number of core vents and location.
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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 flue.
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- None
Front Elevation.
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Cavity Depth.
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
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Add drawing
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Photo of elevation .
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Please mark the position of the Boroscope hole with an S on the elevation drawing.
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Boroscope Photos.
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Comments
Rear Elevation
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Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
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Add drawing
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Photo of elevation
-
Please mark the position of the Boroscope hole with an S on the elevation drawing.
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Boroscope Photos.
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Comments
Right hand elevation
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Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
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Add drawing
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Photo of elevation
-
Please mark the position of the Boroscope hole with an S on the elevation drawing.
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Boroscope Photos.
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Comments
Left hand elevation
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Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
-
Add drawing
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Photo of elevation
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Please mark the position of the Boroscope hole with an S on the elevation drawing.
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Boroscope Photos.
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Comments
Building extensions
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Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
-
Add drawing
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Photo of elevation
-
Please mark the position of the Boroscope hole with an S on the elevation drawing.
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Boroscope Photos.
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Comments
Summary of your finding and reasons for the extraction of the existing cavity wall insulation:
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Add signature
Dynamic Risk Assessment & Client Declaration
Dynamic Risk Assessment.
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Reversing vehicle.
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Asbestos.
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Overhead electricity cables.
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Use of a step ladders or ladder.
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Use of a mobile tower.
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Manual Handling.
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Working on a roof.
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Hand tools.
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Vibration.
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Noise.
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Electricity/Generator
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Compressed air.
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House keeping.
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Working with wet cement, concrete and mortar.
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Use of mobile elevation working platform (mewp).
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Lone worker.
