Title Page
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Site Address
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Conducted on
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Surveyor
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Resident Name
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Resident contact details (Landline/Mobile)
Gas (relevant Appliance info)
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Boiler Make and Model
- Baxi HE105
- Baxi Duo Tech 28HE
- Ideal Classic FF340
- Baxi HE80
- Baxi Duo Tech 24HE
- Ideal Logic 24
- Ideal Logic 30
- NONE
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Flue Type
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Does Flue need extending
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Is loft accessable
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Location
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Appliance Type
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PRV to extended
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Condensate to extend
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Brief description
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Location of Gas Meter
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2nd Gas Appliance
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Appliance Make and Model
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Flue Type
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Does this need extending
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Location
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Appliance Type
Gas (Non relevant Appliance info)
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Is there any Solid Fuel
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Add details
Gas Pipework and Extra
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Gas pipework alterations required
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Brief Description
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Add Photos
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Flue Basket Required
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Trunking Required
Plumbing
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Outside tap to replace
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Photo
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Waste pipework alterations required
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Details
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Add Photos
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Hopper Head Required
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Are any Overflow extensions required?
Electrical
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Is there a Kitchen Extractor Fan Fitted
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Add Image
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Where is new fan to be installed
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Please add photo
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Is there a Bathroom Extractor fan fitted
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Add Image
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Where is new fan to be installed
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Add Photo
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Burglar Alarm fitted
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Add description (Working, Age & is it Dummy)
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Photo
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Any CCTV present
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Description (Working, Age, Number of units & is it Dummy)
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Photo
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Any external Power feeds to be removed or isolated (Shed)
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Any Outdoor Sockets
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Brief description
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Photo
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Any Outdoor Lighting
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Brief Description
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Photo
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Door Bell adjustment required
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Brief Description
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Dryer Vent Required
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Photo
Survey Completion
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Any additional comments
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Residents Signiture
