Title Page
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Customer
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Location
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Conducted on
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Prepared by
Occupant Details
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Property Tenure
- Owner/Occupied
- Council
- Housing Association
- Private Let
- Mixed Tenure (Flats)
- Other
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Full Name of Owner
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Full Name of Tenant
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Which Council/Housing Association Owns the Property?
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Name of Person Responsible For Maintenance of property?
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Contact Number
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Full Name of Tenent
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Name of Landlord
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Address of Landlord
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Landlord Contact Number
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Provide Full Details
Property Details
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Property Type
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Attachment Of Property
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Year of Construction
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Elevations
Property Inspection
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Is The Roofing in Good State of Repair?
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State Roof Covering (Tile/Slate Etc...)
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Roof
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Does Gutter Have Lining Installed?
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Is Lining in Good Condition?
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Evidence
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Is Gutter Lining Free From Weeds & Debris?
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Evidence
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Is Install Part of an Extract and Refill?
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Material Being Extracted
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Reason For Extraction
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Has The Cavity Been Fully Cleared of Material and Rubble?
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Evidence
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Is The Underside of Finlock Clear of any Gaps and Water ingress within the Cavity?
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Evidence
Customer Sign off & Declaration
Sign Off & Declaration
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Parties Signing below have been made fully aware of the contents of this independent survey carried out by the System Designer and Manufacturer of the cavity wall insulation product intended to be installed within this property.
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Survey Outcome
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The installer agrees to comply with all aspects of the system designer during installation. The installer is aware that deviating from system design or recommendations from the system designer could impede the performance of the specified product.
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Installer Comments
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On Behalf of Installer
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I agree to complete all remedial works stated prior to install
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The owner of this property understands and agrees that the products performance used in this install is only suitable if the properties Finlocks are property maintained, this includes yearly inspections and possible cleaning of the lining. Failure to carry out these checks will invalidate any product warranty and possibly other guarantees issued by third parties. Failure of the Finlock lining may cause further damages to other areas of the building fabric
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Owner Comments
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Owner Signature
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I confirm that I have assessed this property to the best of my knowledge and believe that all content with in this survey is true. all information has been explained to both Installer and Customer and the consciences of not following design.
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Inspectors Comments
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Inspectors Signature
