Information
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Location.
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First line of the Address.
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Client Name.
- Alliance Homes
- Abri
- Cornwall Housing
- Curo
- Homes in Sedgemoor
- Ian Williams (East Devon)
- North Devon Homes
- Livewest
- PCH
- Somerset West and Taunton
- Sovereign Housing
- Westwood Housing
- WMS Ltd
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Tenure.
- Owner occupier
- Local Authority
- Housing Association
- Privately Rented
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Contact Details.
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Property Type.
- Mid-Terrace
- End terrace
- Semi-detached
- Detached
- Ground Floor Flat
- Middle Floor Flat
- Top Floor Flat
- Maisonette
- Bungalow
- House
- Commercial Building
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Number of Bedrooms.
- 1
- 2
- 3
- 4
- 5+
- N/A Commercial
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Floor construction Type
- Solid
- Suspended
- Block and beam
- Suspended and solid
- Other
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Construction age of Building.
Property details
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Survey conducted by.
- Vinnie Stokes
- Sean Glossop
- Rob Mckenna
- Alister Paisley
- Nick Hyett
- Steve Britton
- Lee Glenister
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Confirmation that relevant checks have been undertaken to determine if the presence of any asbestos containing material is present?
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Please take a photo of the building finish on all elevations and select the finish types.
- Brick
- Brick/Render
- Painted Render
- Recon Stone/Sand Stone
- Pebble Dash/Spar
- Tile hung cladding
- PVC cladding
- Timber cladding
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If painted render please provide the best colour match:
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Structural Condition.
- Very good
- Good
- Poor
- Very poor
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External Condition of the building.
- Very good
- Good
- Poor
- Very poor
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Is the property suitable to receive the insulation type specified?(Construction Type, Exposer, Condition of Structure)
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Remedial Works Required, If yes please give details of remedial work required plus photos.
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Are all guttering / downspouts in good repair with no evidence of leaks / spills? In addition, if guttering is a Finlock system has this been lined? (Please take photos of any issues)
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Main Heating type, plus take photos of the appliance and ratings plate or appliance ID.
- Mains Gas/LPG
- Oil
- Solid fuel
- Electric
- Renewable technology/Other
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Please make a visual check around the heating appliance for possible material ingress points.
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Location of the flue.
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- Flue passes through the roof space
- None
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Please take a photo of the flue and combustion vent if fitted.
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Have you checked for any holes around the flue?
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Secondary Heating.
- 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
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If secondary heating is present please take a photo of appliance and KW rating plate if accessible.
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Location of the Chimney.
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- Flue passes through the roof space
- None
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Please take a photo of the position of the chimney.
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Safety monitors present.
- Smoke Alarm
- Fire Alarm
- CO2 Alarm
- No internal access to check for safety monitors
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Have the alarms all been tested by surveyor.
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Protected species or rodents present in building.
Access
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Access Issues please make notes and take photos of any issues.
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On site parking.
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Client Instructions.
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Access Equipment Required.
- None
- Ladders
- Scaffold Board for Flat Roof
- Scaffolding
- Conservatory Ladder
- Roof Ladder
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Inspection to be undertaken i.e Post extraction or cavity wall insulation.
- Post Extraction
- Cavity wall
Post Extraction.
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Inspection type.
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Material Removed/Extracted
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Have you Boroscoped all elevations
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Please take photos of your Boroscope inspection.
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What are the condition of the wall ties?(Please provide at least 5 Photos)
- Good condition
- Signs of corrosion
- Covered in mortar/debris
- Corroded through
- Recommend further investigation due to excessive corrosion
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Are all elevations free of insulation and rubble.
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If you have answered NO please provide a photos of the elevation and mark the area of concern.
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Front elevation
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Rear elevation
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LHS elevation
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RHS elevation
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Have cavity barrier brushes been fitted? Provide photos evidence if you have answered yes and if no please provide a reason.
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Have all extraction holes been made good.(Please take photos)
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Does the finish match the existing mortar.
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Have all essential vents been checked and functioning correctly. (Sealed/Sleeved/Left open)
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If the cavities have been cleaned of a previous CWI Installation, can you confirm the cavities are suitable for re-installation?
- Yes please see post extraction report above.
- No, debris needs removing and wall ties cleaning and still a small amount of existing insulation to be removed.
- No, remedial works required before cavities refilled
- No, old insulation still present.
- Having scoped the cavities I'm unable to detect any issues with the existing cavity wall insulation.
Internal Inspection:
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Have you done an internal inspection of the building? Including access to the loft space.(Please take photos of the loft and any damp found in the property)
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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
- No internal issues that I can see.
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Has the loft space been checked for material ingress?
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Have the extraction crew stapled a flue certificate in the loft?
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Has a smoke spillage test been carried out on all fuel burning appliances that pass through the cavity?
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Is there any sign of material ingress post extraction.
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Was there moisture transfer due to failed CWI? If yes please provide information on which rooms.
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Add signature
Cavity Wall Insulation
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If you are carrying out a cavity wall survey please select Cavity wall from the drop down.
Cavity Wall Insulation:
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Scheme Type
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Required material.
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Total area to be insulated.
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Total area to be omitted.
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Photos of omitted areas.
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Please take a photo of the overall cavity width across a door or window reveal.
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Please select the type of ventilation present, including extraction ventilation and trickle vents.
- Bedroom ventilation
- Combustion ventilation
- Bathroom ventilation or extraction fan
- Kitchen ventilation or extraction fan
- Pantry vents
- Underfloor vents
- Trickle vents
- None
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Please take a photo of all vents and extraction fans fitted within the property including at lease two photos of window trickle vents.
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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.
- Bedroom ventilation
- Combustion ventilation
- Bathroom ventilation or extraction fan
- Kitchen ventilation or extraction fan
- Pantry vents
- Underfloor vents
- Trickle vents
- None
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Adjoining properties insulated ?
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Number of Cavity brushes required.
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Combustion core vent required.
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Number of combustion vents required.
If funding available please answer additional ventilation questions below.
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If funding available please select yes.
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Are there any visible signs of surface condensation or damp?
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Does the property meet the minimum acceptable ventilation requirements set out in PAS 2035?
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Does the cooker have a hood which ventilates to the outside?
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Is there an airing cupboard or drying room that is ventilated to the outside?
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Is there a tumble dryer which is vented to the outside of the property?
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Do all wet rooms have as a minimum some from of passive or purge ventilation? (opening windows, air bricks or trickle vents)
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Do all wet rooms have closing doors?
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Is there a passive ventilation system?
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Is there a mechanical ventilation system? (Continuous mechanical extract ventilation, Continuous mechanical ventilation with heat recovery)
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Is there evidence of intermittent heating to parts of the property ?e.g TRV's being turned down too low to unused areas.
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Are there appropriate controls in place to regulate the heating in the property?(thermostat, programmer etc)
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Is the thermostat set to a minimum of 10 Celsius in all parts of the property that are heated?
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Is there evidence of cloths being dried in the property?
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Are there more bedrooms than occupants?
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Is there single glazing at the property?
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Has the importance of behavior to moisture and condensation been explained to the occupants and left behind?
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Is there a condensation calculation required?If so what elements?
Front Elevation.
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Photo of the elevation
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Please mark the position of the Boroscope hole with an S on the elevation photo.
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Please take a photo of the DPC showing a tape measure on each elevation.
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Photos of tape measure in the cavity.
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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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Comments
Rear Elevation
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Photo of the elevation
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Please mark the position of the Boroscope hole with an S on the elevation photo.
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Please take a photo of the DPC showing a tape measure on each elevation.
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Photos of tape measure in the cavity.
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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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Comments
Right hand elevation
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Photo of the elevation
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Please mark the position of the Boroscope hole with an S on the elevation photo.
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Please take a photo of the DPC showing a tape measure on each elevation.
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Photos of tape measure in the cavity.
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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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Comments
Left hand elevation
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Photo of the elevation
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Please mark the position of the Boroscope hole with an S on the elevation photo.
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Please take a photo of the DPC showing a tape measure on each elevation.
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Photos of tape measure in the cavity.
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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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Comments
Building extensions
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Photo of the elevation
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Please mark the position of the Boroscope hole with an S on the elevation photo.
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Please take a photo of the DPC showing a tape measure on each elevation.
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Photos of tape measure in the cavity on each elevation.
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Cavity Depth
- Yes please see post extraction report above.
- No, debris needs removing and wall ties cleaning and still a small amount of existing insulation to be removed.
- No, remedial works required before cavities refilled
- No, old insulation still present.
- Having scoped the cavities I'm unable to detect any issues with the existing cavity wall insulation.
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Comments
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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Installation of cavity wall.
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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.
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Confirmation that the customer has been notified that Bierce or the BBA (British Board of Agreement) may contact them to arrange a visit to confirm suitability of the property? (we must inspect 10% so we will need to have an agreement about sharing customer’s data as we need to make appointments)
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I have assessed the conditions on site ensuring there is adequate ventilation and no evidence of damp and no remedial works required. 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
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Clients Signature
Installation checks (to be completed by technician at install)Cavity wall.
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Crew leader.
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No.2
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Date:
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Crew leader signature.
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Have you stapled the flue certificate in the loft space? If no loft access please leave the flue certificate with the occupants.
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Cavity width(mm)
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Gables installed:
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Jet size used:
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Total m2 insulated.
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Pipe 1 Glue Flow in ml:
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Pipe 1 Bead Flow in kg:
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Pipe 2 Glue Flow in ml:
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Pipe 2 Bead Flow in kg:
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Number of barrier brushes fitted ?
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Number of cove vents fitted ?
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Number of vents replaced ?
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We're pre installation checks carried out ?
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We're post installation checks carried out ?
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Customer signature.