F230:Loft Insulation Survey V1.2

• Location.
  Address

• First line of the Address.

• Client Name:

  Select Somerset West and Taunton Alliance Homes Cornwall Housing Ian Williams(East Devon) Sovereign Housing Bromford Housing Homes in Sedgemoor Livewest Yarlington Housing Group North Devon Homes Cottsway Housing LEAP

  • Somerset West and Taunton
  • Alliance Homes
  • Cornwall Housing
  • Ian Williams(East Devon)
  • Sovereign Housing
  • Bromford Housing
  • Homes in Sedgemoor
  • Livewest
  • Yarlington Housing Group
  • North Devon Homes
  • Cottsway Housing
  • LEAP

• Type of Survey

  Loft Insulation

  Loft space report no works

• Tenure.

  Select Owner occupier Local Authority Housing Association Privately Rented

  • Owner occupier
  • Local Authority
  • Housing Association
  • Privately Rented

• Contact Details.

• Property Type.

  Select Mid-Terrace End terrace Semi-detached Detached Ground Floor Flat Middle Floor Flat Top Floor Flat Masonette Bungalow House Commercial Building

  • Mid-Terrace
  • End terrace
  • Semi-detached
  • Detached
  • Ground Floor Flat
  • Middle Floor Flat
  • Top Floor Flat
  • Masonette
  • Bungalow
  • House
  • Commercial Building

• Building Finish.

  Select Brick Painted Render Brick/Render Pebble Dash Recon Stone Spar Limestone/Sandstone Granite/Whinstone

  • Brick
  • Painted Render
  • Brick/Render
  • Pebble Dash
  • Recon Stone
  • Spar
  • Limestone/Sandstone
  • Granite/Whinstone

• Number of Bedrooms.

  Select 1 2 3 4 5+ N/A Commercial

  • 1
  • 2
  • 3
  • 4
  • 5+
  • N/A Commercial

• Construction age of the property.

• Survey conducted by.

  Select Vinnie Stokes Sean Glossop Rob Mckenna Alister Paisley David Fox Nick Hyett Lee Glenister Steve Britton

  • Vinnie Stokes
  • Sean Glossop
  • Rob Mckenna
  • Alister Paisley
  • David Fox
  • Nick Hyett
  • Lee Glenister
  • Steve Britton

• Main Heating type, please take photos of the appliance and the rating plate or appliance ID.

  Mains Gas/LPG

  Oil

  Solid Fuel

  Electric

  Renewable Technology/Other

• Location of the flue.

  Select Internal External Front Elevation Rear Elevation Left Hand Elevation Right Hand Elevation Does the flue pass thought the loft space None

  • Internal
  • External
  • Front Elevation
  • Rear Elevation
  • Left Hand Elevation
  • Right Hand Elevation
  • Does the flue pass thought the loft space
  • None

• Secondary heating.

  Select 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

  • 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

• If secondary heating present please take a photo.

  Yes

  No

  N/A

• Structural Condition of the roof.

  Select Very good Good Poor Very poor

  • Very good
  • Good
  • Poor
  • Very poor

• External Condition of the building.

  Select Very good Good Poor Very poor

  • Very good
  • Good
  • Poor
  • Very poor

• Remedial Works Required.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• If yes please give details of remedial work required plus photos.

  Yes

  No

  N/A

• Have you do an internal inspection of the building.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• If you have answered yes please select the best description of your findings.

  Select Damage to ceiling Water stain on ceiling 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.

  • Damage to ceiling
  • Water stain on ceiling
  • 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.

• Please take photos of your internal findings.

  Media

• Safety monitors present.

  Select Smoke Alarm Fire Alarm CO2 Alarm

  • Smoke Alarm
  • Fire Alarm
  • CO2 Alarm

• Have the alarms all been tested by surveyor.

• Protected species or rodents present in building.

  Yes

  No

  N/A

• Special Instructions.

Access

• On site parking.

• Client Instructions.

• Access Issues.

  Yes

  No

  N/A

• Access Equipment Required.

  Select None Ladders Scaffold Board for Flat Roof Scaffolding Conservatory Ladder Roof Ladder

  • None
  • Ladders
  • Scaffold Board for Flat Roof
  • Scaffolding
  • Conservatory Ladder
  • Roof Ladder

Loft Insulation.

• Is loft to be insulated.

  Select Yes loft requires topping up No Loft has sufficient insulation Unable to check due to the amount of tenants belongings.

  • Yes loft requires topping up
  • No Loft has sufficient insulation
  • Unable to check due to the amount of tenants belongings.

• Photo of loft and access point

  Media

• Area to be insulated.

• Existing Depth.

  Select 0mm 12mm 25mm 50mm 70mm 80mm 100mm 125mm 150mm 170mm 200mm 250mm 270mm 300mm plus

  • 0mm
  • 12mm
  • 25mm
  • 50mm
  • 70mm
  • 80mm
  • 100mm
  • 125mm
  • 150mm
  • 170mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm plus

• Photo of existing depth.

  Media

• Depth to be added.

  Select Existing over 250mm 100mm 150mm 170mm 200mm 250mm 270mm 300mm

  • Existing over 250mm
  • 100mm
  • 150mm
  • 170mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm

• Pipes and Tanks Present

  Yes

  No

  N/A

• Details of Pipes and Tanks to be insulated

• Down lights present in ceiling?

  Yes

  No

  N/A

• Details of down lights, how many and there current location

• Do they have halogen bulbs fitted.

  Yes

  No

  N/A

• Can you see the IP rating on the casing?

  Yes

  No

  N/A

• Please take a photo of the down light IP rating.

  Media

• Are there any existing down light covers fitted?

  Yes

  No

  N/A

• If YES are they fire rated covers?

  Yes

  No

  N/A

• Electrical wiring free from visual defects?

  Yes

  No

  N/A

• Are there any high voltage cable's in the loft space.

  Yes

  No

  N/A

• If YES please select the type of cable in the loft space.

  Cooker cable

  Shower cable

  Immersion cable

  PV cable

• Loft Hatch Size?

• Loft Area.

  Drawing

• In your opinion should loft be Rolled or Blown?

  Rolled

  Blown

• Loft Height at Centre

  Select 0.80 metres 0.90 metres 1.00 metres 1.20 metres 1.40 metres 1.50 metres 1.60 metres 1.80 metres and above.

  • 0.80 metres
  • 0.90 metres
  • 1.00 metres
  • 1.20 metres
  • 1.40 metres
  • 1.50 metres
  • 1.60 metres
  • 1.80 metres and above.

• Does a steel combustion flue pass through the loft space?

  Yes

  No

  N/A

• Relay Required

  Yes

  No

  N/A

• Loft hatch needing D/P

  Yes

  No

  N/A

• Loft vents required

  Yes

  No

  N/A

• Areas to be omitted

  Yes

  No

  N/A

• Does the loft have any boarding?

  Yes

  No

  N/A

• If YES can we insulate at lease 2/3 of the loft space?

  Yes

  No

  N/A

• has the boarded area insulation under it?

  Yes

  No

  N/A

• If not insulated under, are the joist tunnels tightly sealed with insulation at the ends?

  Yes

  No

  N/A

• Walkway required

  Yes

  No

  N/A

• Details of walkway

• Loft clearance

  Yes

  No

  N/A

• Details of loft clearance

• Additional notes

Dynamic Risk Assessment.

• Please select yes if loft insulation work as to be installed.

  Yes

  No

  N/A

• Reversing vehicle.

  Yes

  No

  N/A

• Asbestos

  Yes

  No

  N/A

• Overhead electricity cables.

  Yes

  No

  N/A

• Use of a step ladders.

  Yes

  No

  N/A

• Use of a ladder.

  Yes

  No

  N/A

• Manual Handling.

  Yes

  No

  N/A

• Hand tools.

  Yes

  No

  N/A

• Vibration.

  Yes

  No

  N/A

• Noise.

  Yes

  No

  N/A

• House keeping.

  Yes

  No

  N/A

• Use of mobile elevation working platform (mewp) or a scaffold tower.

  Yes

  No

  N/A

• Lone worker.

  Yes

  No

  N/A

• 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.

  None

  See Below

• Assessors signature

  Sign

Installation checks to be completed by technician after the work as been completed.

• Please select yes if loft insulation work as to be installed.

  Yes

  No

  N/A

• Crew leader name:

• No 2 technician:

• Date.

• Crew leader signature.

• Materials used:

• Roll Matt 100mm

• Roll Matt 150mm

• Roll Matt 170mm

• Roll Matt 200mm

• Roll Matt 250mm

• Roll Matt 270mm

• Roll Matt 300mm

• Pipe lagging 15mm

• Pipe lagging 22mm

• Pipe lagging 28mm

• Pipe wrap per metre

• Cold water tank jacket small

• Cold water tank jacket medium

• Cold water tank jacket large

• Hot water tank jacket

• Poly wedges installed

• Customer signature: