Internal Survey Revised v2

• Job Number

• Conducted on

  Date

• Prepared by

• Location
  Address
Construction

• Room

• Floor level

• Room Dimensions

• Heat Loss Perimeter

• Ceiling Height

• Any suspected Asbestos

  Yes

  No

  N/A

• Dangerous Gas or Electrical installations (Bare wires etc..)

  Yes

  No

  N/A

• Wall construction

• External wall depth

• Floor construction

• Floor exposed to ground/external air/heated/unheated space

• Any visible cracks/movement

• Any mould/damp/condensation

Doors

• Width

• Height

• Area m2

• Orientation

• Overshading

• Glazing type

• Undercut/Overcut

• Draughtproofing and condition

• Overall condition

• Security/Locking

Windows

• Window type i.e. Internal or External, Triple Glazing etc

• Height

• Width

• Area m2

• Orientation

• Over-shading i.e. Trees/Structures percentage

• Glazing type

• Draught-proofing condition

• Spacer type

• Trickle vents

• Overall condition

• Cill height

• Opening light/skylight etc..

• Security/Locking

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• Yes

  No

  N/A

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• Yes

  No

  N/A
Radiators

• Site plan reference

• Type

• Controls

• Pipework size/type

• Defects i.e. leakages

Underfloor (if applicable/accessible)

• N/A please describe why

• Void depth

• Joist size

• Joist centres

• Joist condition

• Insulation type and depth

• Ventilation i.e. subfloor

• Any visible cracks/movement

• Any Mould/damp/condensation

Ventilation

• Is there a 10mm undercut/overcut on the doors

  Yes

  No

  N/A

• Is there any ventilation present in this room

  Yes

  No

  N/A

• Any fuel burning appliances in this room N.B. KW rating and type

  Yes

  No

  N/A

Water use

• Applicable/not applicable

  Yes

  No

  N/A

• Type of Shower

• Low flow shower head

• Any flow restrictors on taps

• Low flush WC or Cistern restrictors

Lighting/Appliances/Cooking

• Number and type of fixed lights/lamps

• Appliances (i.e. Higher use)

  Yes

  No

  N/A
Rooms and spaces outside of the thermal envelope

• Please provide a brief explanation if N/A

  Yes

  No

  N/A

• How is this space used

• General condition of space

• Depth and condition of any insualtion

• If roof or loft space is there a membrane/felt present

  Yes

  No

  N/A

• If applicable please provide a brief description

• Is there adequate ventilation

  Yes

  No

  N/A

• Are there any signs of condensation/mould/rot

  Yes

  No

  N/A

• How is this space accessed

• Condition of door/hatch i.e. insulated

• Any Electrical/Gas supplies in this space

  Yes

  No

  N/A

• Any suspected Asbestos in this space

  Yes

  No

  N/A