Information
-
Conducted on
-
Prepared by
-
Date
-
Standard/Arranged
-
Cold call
Referral Source
-
Source
- Phone Call
- Letter
- Other
Tenant/Homeowner Details
-
Name
-
Address
-
Phone Number
-
Mobile Number
-
Email Address
-
Preferred Time of Contact
- Morning
- Afternoon
- Evening
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
-
Preferred Contact Method
- Landline
- Mobile
- Letter
Client/Landlord Details
-
Name
-
Address
-
Phone Number
-
Mobile Number
-
Email Address
-
Preferred Method of Contact
- Phone Call
- Letter
- Other
-
Preferred Time of Contact
- Morning
- Afternoon
- Evening
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
Property details
Property Details
-
Property Type
- Mid-Terrace
- End terrace
- Semi-detached
- Detached
- Lower Flat
- Middle Flat
- Top Flat
- Masonette
- Other
-
Building finish
-
Number of Bedrooms
-
Type of Heating
- Gas
- Oil
- Solid Fuel
- Electric
- Other
-
Insulation Works Required
- Loft Insulation
- Cavity Wall Insulation
- Draught Proofing
- Extraction
- Underfloor Insulation
- Internal Wall Insulation
- Spray Foam Insulation
-
Structural condition
-
External Wall Condition
-
Remedial works required
-
Adequate ventilation to work area
-
Dampness or water damage
-
Photo of each elevation
-
Building defects
-
Protected species or rodents
-
Safety monitors present
- Smoke Alarm
- Fire Alarm
- CO2 Alarm
- Cold Alarm
-
Have the alarms all been tested by surveyor
-
Special Instructions
Access
-
On site parking
-
Client Instructions
-
Access Issues
-
Access Equipment Required
- None
- Ladders
- Tower
- Scaffolding
- Cherry Picker
- Scissor lift
- Spider
- Conservatory Ladder
Cavity Wall Insulation
Details
-
Test
-
Total area to be insulated
-
Required material
-
Average Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
-
Boroscope photo
-
Total area to be omitted
-
Photos of omitted areas
-
Number of air bricks
-
HTT reason
-
Number of Cavity brushes required
-
Core vent required
-
Photo of any defects
-
List any defects
-
List all access issues
-
Photo of access issues
-
Location of chimneys
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- None
-
Location of flue
- Internal
- External
- Front Elevation
- Rear Elevation
- Left Hand Elevation
- Right Hand Elevation
- None
Front Elevation
-
Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
-
Photo of elevation
-
Comments
Rear Elevation
-
Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
-
Photo of elevation
-
Comments
Right hand elevation
-
Cavity Depth
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 105mm
- 110mm
- 115mm
- 120mm
- 125mm
- 130mm
- 135mm
- 140mm
- 145mm
- 150mm
- 155mm
- 160mm
- 165mm
- 170mm
- 175mm
- 180mm
- 185mm
- 190mm
- 195mm
- 200mm
-
Photo of elevation
-
Comments
Left hand elevation
-
Cavity Depth
-
Photo of elevation
-
Comments
Extraction
-
Total area to be extracted
-
Reason for extraction
-
Material being extracted
-
Recommended cavity drying time
-
Are all apertures sealed internally
-
Moisture reading results
-
Has client been advised on extent on drilling and core holes
Loft Insulation
-
Photo of loft
-
Area to be insulated
-
Existing Depth
- 0mm
- 50mm
- 70mm
- 100mm
- 150mm
- 200mm
- 250mm
- 270mm
- 300mm
-
Photo of existing depth
-
Depth to be added
-
Loft drawing
-
Relay Required
-
Please note any pipe work that required lagging
-
Loft hatch needing D/P
-
Loft vents required
-
Areas to be omitted
-
Walkway required
-
Loft clearance
-
Additional notes
Draught Proofing
-
Loft hatch
- Brown
- White
- Bottom Brush
- O Tube
- Letterbox Cover
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
Add media
-
Internal Door
- Brown
- White
- Bottom Brush
- O Tube
- Letterbox Cover
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
Add media
-
External Door
- Brown
- White
- Bottom Brush
- O Tube
- Letterbox Cover
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
Add media
-
Standard window
- Brown
- White
- Bottom Brush
- O Tube
- Letterbox Cover
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
Add media
-
Sash windows
- Brown
- White
- Bottom Brush
- O Tube
- Letterbox Cover
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
-
Add media
Dynamic Risk Assessment & Client Declaration
Dynamic Risk Assessment
-
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.
-
Assessors signature
Quotation
Quotation
Cavity wall insulation
-
Total m2
-
Price
Extraction
-
Total m2
-
Price
Loft
-
Total m2
-
Price
DP
-
Total m2
-
Price
Other works
-
Total m2
-
Price
Access equipment
-
Price
Total price
-
Price
