Title Page
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Job Number
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Date of Survey
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Surveyor
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Address
Consruction
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Room name
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Floor Level
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Room Dimensions
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Heat Loss Perimeter
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Ceiling Height
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Any suspected Asbestos
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Dangerous Gas or Electrical Installations? (Bare wires etc..)
- Yes
- No
- N/A
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Dangerous Gas or Electrical Installations? (Bare wires etc..)
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Wall Construction
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External Wall Thickness
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Floor Construction type
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Floor exposed to ground/external air/heated space/unheated space
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Any visible cracks/movement
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Any mould/damp/condensation
Windows and Doors
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Type (window or door = door internal and external) and Location on Site Plan
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Width
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Height
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Area
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Orientation
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Overshading percentage
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Glazing type
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Draughtproofing condition
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Spacer Type
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Trickle vents
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Overall condition
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Cill height
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Opening light
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Security/Locking
Radiators
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Type
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Controls
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Pipework size/type
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Defect
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Location identifier on plan
Underfloor (if applicable/accesssible)
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Void depth
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Joist size
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Joist spacing (i.e. centres)
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Joist condition
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Insulation (type and depth)
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Ventilation
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Any visible cracks/movement
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Any mould/damp/condensation
Ventilation
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Is there a 10mm undercut/overcut
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Is there any ventilation present in the room
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Fuel burning appliances in this space (KW size and type)
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Add media
Water Use
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Type of shower
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Low flow shower head
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Any flow restrictions on taps
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Low flush WC or cistern restrictor
Lighting/Appliances/Cooking
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Number and type of fixed lights and lamps
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Appliances
Rooms and spaces outside the thermal envelope
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How is this space used
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General condition of this space
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Insulation material type and depth
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Is there felt or membrane present (type and condition)
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Ventilation and any condensation build up
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How is this space accessed
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Is the access hatch/door in condition and insulated
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Any electrical or gas supply cables in this space
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Is there any asbestos
