Title Page

  • Conducted on

  • Prepared by

  • Client and Tenure

  • Survey Type

  • First Line of Address

  • GPS

Resident and Occupancy Details

Customer Details

  • Resident Name

  • Resident Contact Number

  • Resident Email

  • Best Days for Installation / Days to Avoid

  • Current Energy Supplier

  • Is More Detailed Occupancy Information Required?

  • Is the occupancy considered typical for the property?

  • How many people live in the property?

  • Is the occupancy due to change within the foreseeable future?

  • Is there a thermostat?

  • Is the thermostat maintained at a typical temperature?

  • Is this due to the thermostat temperature being considered higher or lower than typical?

  • Is the heating pattern considered typical for the property?

  • Is this due to the heating pattern being considered higher or lower than typical?

  • Does the customer utilise all heat emitters within each room that contains them?

  • Has the customer been made aware of the process of gathering personal data and relevant Data Protection policies?

  • Can you identify any existing Energy Efficiency Measures that have been installed?

  • Current Energy Efficiency Measures

  • Do you believe that all current Energy Efficiency Measures are being used correctly?

Basic Property Details

  • Property Type

  • What Type

  • Attachment

  • Building Finish

  • Construction Type

  • Structural Condition of Wall

  • Remedial Works Required

  • Details of remedial works and photos

  • Photo of remedial works required

  • Age Band

  • Listed Building / Conservation Area

  • Details

  • Number of Storeys

  • Floor Construction Type

  • Structural Condition

  • Number of Bedrooms

  • Number of Bathrooms

  • Main Heating Type?

  • Photographic Evidence

  • Secondary Heat source?

  • Photographic Evidence

  • Safety Monitors Present

  • Have all alarms been tested?

  • Protected Species or Rodents Present in the Building

  • On Site Parking

  • Any Access Issues

  • What Issues are Present

Loft Insulation Survey

  • Is Loft Insulation a Proposed Measure?

  • Is loft to be insulated.

  • Photo of loft and access point

  • Loft Hatch Size?

  • Area to be insulated.

  • Existing Depth.

  • Photo of existing depth.

  • Depth to be added.

  • Pipes and Tanks Present

  • Details of Pipes and Tanks to be insulated

  • Down lights present in ceiling?

  • Details of down lights, how many and there current location

  • Do they have halogen bulbs fitted.

  • Can you see the IP rating on the casing?

  • Please take a photo of the down light IP rating.

  • Are there any existing down light covers fitted?

  • If YES are they fire rated covers?

  • Electrical wiring free from visual defects?

  • Are there any high voltage cable's in the loft space.

  • If YES please select the type of cable in the loft space.

  • In your opinion should loft be Rolled or Blown?

  • Loft Height at Centre

  • Does a steel combustion flue pass through the loft space?

  • Relay of Insulation Required?

  • Loft hatch needing D/P

  • Loft vents required

  • Areas to be omitted

  • What Areas?

  • Does the loft have any boarding?

  • If YES can we insulate at lease 2/3 of the loft space?

  • Has the boarded area got insulation under it?

  • If not insulated under, are the joist tunnels tightly sealed with insulation at the ends?

  • Walkway required

  • Details of walkway

  • Loft clearance

  • Details of loft clearance

  • Additional notes

Cavity Wall Insulation Survey

  • Is Cavity Wall Insulation a Proposed Measure?

  • Required material.

  • Total area to be insulated.

  • Total area to be omitted.

  • Photos of omitted areas.

  • Average Cavity Depth

  • Please take a photo of the overall cavity width across a door or window reveal.

  • Please select the type of ventilation present, including extraction ventilation and trickle vents.

  • Please take a photo of all vents and extraction fans fitted within the property including at least 2 photos of window trickle vents.

  • Do any of the air vents require sleeving or sealing up before installing the cavities.

  • If yes please select the air vents that require sleeving or sealing up.

  • Adjoining properties insulated ?

  • Number of Cavity brushes required.

  • Location of Flue

  • Combustion core vent required.

  • Number of combustion vents required.

Front Elevation.

  • Cavity Depth.

  • Photo of the elevation inc Boroscope hole marked with an S.

  • Borescope Photos

  • Photo of DPC showing a tape measure

  • Photos of tape measure in the cavity.

  • Comments

Rear Elevation

  • Cavity Depth

  • Photo of the elevation inc Boroscope hole marked with an S.

  • Borescope Photos

  • Photo of DPC showing a tape measure

  • Photos of tape measure in the cavity.

  • Comments

Right hand elevation

  • Is there a right hand elevation on this property

  • Cavity Depth

  • Photo of the elevation inc Boroscope hole marked with an S.

  • Borescope Photos

  • Photo of DPC showing a tape measure

  • Photos of tape measure in the cavity.

  • Comments

Left hand elevation

  • Is there a left hand elevation on this property

  • Cavity Depth

  • Photo of the elevation inc Boroscope hole marked with an S.

  • Borescope Photos

  • Photo of DPC showing a tape measure

  • Photos of tape measure in the cavity.

  • Comments

Building extensions

  • Is there an extension on this property

  • Cavity Depth

  • Photo of the elevation inc Boroscope hole marked with an S.

  • Borescope Photos

  • Photo of DPC showing a tape measure

  • Photos of tape measure in the cavity on each elevation.

  • Comments

Additional Ventilation Questions if Funding is Available

  • If funding available please select YES.

  • Are there any visible signs of surface condensation or damp?

  • Photographic Evidence

  • Does the property meet the minimum acceptable ventilation requirements set out in PAS 2035?

  • Does the cooker have a hood which ventilates to the outside?

  • Is there an airing cupboard or drying room that is ventilated to the outside?

  • Is there a tumble dryer which is vented to the outside of the property?

  • Do all wet rooms have as a minimum some from of passive or purge ventilation? (opening windows, air bricks or trickle vents)

  • Do all wet rooms have closing doors?

  • Is there a passive ventilation system?

  • Is there a mechanical ventilation system? (Continuous mechanical extract ventilation, Continuous mechanical ventilation with heat recovery)

  • Is there evidence of intermittent heating to parts of the property ?e.g TRV's being turned down too low to unused areas.

  • Are there appropriate controls in place to regulate the heating in the property?(thermostat, programmer etc)

  • Is the thermostat set to a minimum of 10 Celsius in all parts of the property that are heated?

  • Is there evidence of cloths being dried in the property?

  • Are there more bedrooms than occupants?

  • Is there single glazing at the property?

  • Has the importance of behaviour to moisture and condensation been explained to the occupants and left behind?

  • Is there a condensation calculation required? If so what elements?

External Wall Insulation Survey

  • Is an external wall insualtion survey required?

  • Number of elevations to be treated

  • Does the wall have cavity insulation?

  • If no, has the cavity been sealed at the perimeter?

  • Need for fire separation of the compartments/Boundaries defined:

  • EEM Design: Accounts for the Building Regulation requirements for fire:

EEM DESIGN:

  • Design accounts for building exposure:

  • Design accounts for loading in service e.g Impact:

  • Comments

  • Design eliminates thermal bridging:

  • Design minimises thermal bridging

Existing Finishes: External/Internal

  • Agrees with Retro fit Assessment and Design

  • External Finishes

  • Please state other type of finish.

  • Internal: Colours & Textures

  • Other internal finishes please specify:

  • Comments:

Through Wall Construction

  • Internal to external surface layers

  • Overall Wall Thickness

  • Photo of wall thickness

  • Layer 1

  • Layer 2

  • Layer 3

  • Layer 4

  • Layer 5

  • Layer 6

  • Layer 7

  • Has a second through wall construction been identified ?

  • Overall Wall Thickness

  • Photo of wall thickness

  • Layer 1

  • Layer 2

  • Layer 3

  • Layer 4

  • Layer 5

  • Layer 6

  • Layer 7

  • Has a third through wall construction been identified ?

  • Overall Wall Thickness

  • Photo of wall thickness

  • Layer 1

  • Layer 2

  • Layer 3

  • Layer 4

  • Layer 5

  • Layer 6

  • Layer 7

Property Elevation Photos

  • Which Elevations exist on this property

  • Photos

Property Measurements:

  • Property Sketch Photos with Measures

Enabling

  • Satellite Dish works (qty)

  • TV Ariel (qty)

  • External Lights (qty)

  • Alarms (qty)

  • CCTV (qty)

  • Electric Cables (description and lm)

  • Satellite Cables (lm)

  • Electric Box (Type and qty)

  • BT Box (qty)

  • Gas Box (Type and qty)

  • Gas Flue (position and qty)

  • Gas Pipework (lm)

  • Condense Pipework (lm)

  • PRV (qty)

  • Overflow (qty)

  • External Tap (qty)

  • Downpipes (Number of downpipes and lm)

  • Soil and Vent Pipe (connections and lm)

  • Vent Pipe (lm)

  • Through soffit (Y/N)

  • Gates (Material and qty)

  • Fence panels (material and qty)

  • Fence posts (material and qty)

  • Walls (construction type and description)

  • Canopy/Porch (material and qty)

  • Vegetation (day work estimation)

  • Handrail (material and lm/brackets)

  • Grab rails (material and qty)

  • Scaffolding Bridge (qty)

  • Window Cills (over or under)

  • Insulated Plinth Detail (lm)

STRUCTURAL DEFECTS (E.g. Cracking, subsidence,weak or cored components):

  • Is there any evidence of structural defects ?

  • What are the Details?

  • Requires Competent Person e.g. Structural Engineer

  • Photos of Structural Defects

  • EEM Design:

  • Structural repairs included in the design before works start

  • Structural repair to be carried out by others before works start

  • Site pull-out tests undertaken for mechanical fixings

  • System fixing design calculated for all loading conditions ( wind,system weight etc.)

  • Design eliminates thermal bridging

  • Design minimises thermal bridging

  • Interface design details( weather seals etc.) comply with requirements of PAS 2030 2019

EXISTING RENDER:

  • Comments:

  • Comments on apparent defects

  • Agrees with Retrofit Assessment/Design

  • Photo(s)

  • EEM Design:

  • Requires removal, partial removal, repair

  • Render repair included in the design

  • Render repair measure to be carried out by others prior to works.

PRESENCE OF DAMP (RISING, PENETRATING OR CONDENSATION):

  • Comments

  • Comments on damp

  • Photo(s)

  • EEM Design:

  • Damp treatment included in the design

  • Damp treatment measure to be carried out by others prior to works starting.

FROST DAMAGE:

  • Comments

  • Photo(s)

  • EEM Design:

  • Frost repair included in the design

  • Frost repair measure to be carried out before

DETAIL/LOCATION OF MOVEMENT JOINTS:

  • Are there Movement Joints

  • Comments of movement joints

  • Photo(s)

  • EEM Design:

  • Included in the design

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Interface design details (weather seals etc.) comply with the requirements of PAS 2030 2019

MOSS/LICHEN/MOULD/IVY or EFFLORESCENCE

  • Is MOSS/LICHEN/MOULD/IVY or EFFLORESCENCE present

  • Comments of growth

  • Photo(s)

  • EEM Design:

  • Remediation included in the design

  • Design eliminates cold bridging

  • Design minimises cold bridging

  • Interface design details (weather seals etc.) comply with requirements of PAS 2030 2017

WINDOWS/DOOR MATERIAL:(Timber/PVC/Other):

  • Photo(s):

  • Window material type

  • Window Renewal

  • Door material type

  • External Door Renewal

  • EEM Design:

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Interface design details (weather seals around cill, window frame etc.) comply with requirements of PAS 2030/2019

  • Comments:

EXTERNAL SERVICES/ATTACHMENTS TO THE WALLS e.g (Satellite dish, lights):

  • Photo(s)

  • EEM Design:

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Interface design details (weather seals around cill, window frame etc) comply with requirements of PAS 2030/2019

  • Comments:

EXTERNAL ELECTRICAL CABLES/EQUIPMENT:

  • Photo(s)

  • EEM Design:

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Design details (Penetration,fixings, weather seals etc.) comply with requirements of PAS 2030 2019

  • Comments:

EWI ABUTMENT TO EAVES & ROOFS:

  • Photo(s)

  • EEM Design:

  • Design eliminates Thermal bridging (full continuity between wall and the roof insulation)

  • Design minimises Thermal bridging (partial continuity between wall and roof insulation)

  • Interface design details (weather seals etc.) comply with the requirements of PAS 2030/2019

  • Comments:

EWI ABUTMENT TO OTHER STRUCTURES (Conservatories extensions, garden walls, gate posts etc):

  • Photo(s)

  • EEM Design:

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Interface design details (weather seals etc.) comply with requirements of PAS 2030/2019

  • Comments:

RAIN WATER AND DRAINAGE PIPES:

  • Photo(s):

  • EEM Design:

  • Can existing Pipework be moved ?

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Design details (Penetrations, fixings, weather seals, mounting blocks etc.) comply with the requirements of PAS 2030/2019

  • Comments:

DAMP PROOF COURSE(DPC) PROVISION AND LOCATION:

  • Photo(s)

  • EEM Design:

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Design details (E.g Insulated plinth below DPC) complies with requirements of PAS 2030/2019

  • Comments (including any insulated plinth detail and location)

ARCHITECTURAL FEATURES (e.g. protruding stone work, tile sills, soldier courses):

  • Photo(s)

  • EEM Design:

  • Design eliminates Thermal bridging

  • Design minimises Thermal bridging

  • Design details (Penetrations, fixings, weather seals,etc.) comply with requirements of PAS 2030 2019

  • Comments:

Ventilation Survey

  • Is a Ventilation Survey Required

  • Living Room

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Dining Room

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Bedroom 1

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Bedroom 2

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Bedroom 3

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Bedroom 4

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Bedroom 5

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Study

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Other Specify

  • What Room

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Kitchen

  • Has Extractor Fan

  • Extractor Fan Flow Rate

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • Bathroom

  • Has Extractor Fan

  • Extractor Fan Flow Rate

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

  • W/C

  • Has Extractor Fan

  • Extractor Fan Flow Rate

  • Has Required Door Undercuts

  • Has Purge Ventilation

  • Has Trickle Vents / Background Ventilation

  • Photos

PV Survey

  • Is a PV Survey Required

Roof Type

  • Roof Style

  • Tile Type

  • Tile Description (clay or concrete, interlocking or lapped)

Roofing and Scaffold

  • Scaffold Location

  • Height of Eaves?

  • Required Access to rear?

  • Location of rear access

  • Length (along gutter) Metres

  • Height (up roof slope) Metres

  • Pitch ° degrees

  • Height of Roof Above Eaves?

  • Orientation from South (south = 0º East = West =+) degrees

  • Roof type

  • Size of Purlin

  • Number of Purlin supports

  • Maximum Unsupported Rafter Length

  • Rafter/Truss Centres

  • Size of Rafters/Top Chord of Truss

  • Number of Trusses/Rafters

  • Timber Condtion

  • Felt Condition

  • Observations (e.g holes in felt around gas flue)

  • Loft Condition

  • Any Issues With Loft access

  • Loft Headroom Meters

  • Temporary Loft Light Required

  • Temporary Loft Walkway Required

  • Notes

Electrics

  • Consumer Unit Make and Model (e.g. Crabtree, Starbreaker)

  • Breaker Type

  • Location

  • Distribution Board Upgrade?

  • Spare Way for PV

  • Additional Garage DB Required for PV

  • Earthing to Gas Meter

  • Gas Meter Location

  • Earthing to Water Main

  • Water Main Location

  • Earthing Type

  • Notes

Import Meter Type

  • Meter Type

  • Does Meter require changing?

  • Make and Model of Meter

  • Meter Serial Number

  • Is the MPAN Number Present

  • Is there room for the 4 pole isolation switch next to the existing meter

  • Import Meter Location

  • Is it External

  • Is it next to Distribution Board

  • Notes

  • Generation Meter Location (Proposed)

Photovoltaic System Proposed

  • Proposed Inverter Location

  • Can a 600 x 780 board fit on wall and through internal roof access

  • Cellular Networks Checked?

  • Notes

Photo Checklist

  • Property Elevations, Front Door & Scaffold Access

  • Suitable Roof Elevation Close Up including gutter

  • Proposed Inverter Location

  • Roof Void if relevant including TV ariel

  • Consumer Unit and Close up of Breakers

  • Electricity Meter & Mains Fuse / Earth in Meter Box

  • Water main bond

  • Gas Main bond (if applicable)

  • Satellite dish (if any) including closeup of bracket

Shading

  • Has SunEye Survey been completed

  • Notes

Air Source Heat Pump Survey

  • Is an Air Source Heat Pump Survey Required

  • Water Pressure

  • BBU Removal Required

  • Photographic Evidence

  • Fireplace Removal/Block up Required

  • Photographic Evidence

  • Window Material Type

  • Loft Water Tank Removal

  • Electricity Cost per kWh

  • Fuse Board and Main Fuse Cut Out Rating

  • Main Fuse Cut Out Rating

  • Is the mains service looped? (2 cables, 1 coming out to neighbours propoerty)

  • Photographic Evidence

  • Smart Meter Installed?

  • Electric Meter Photographic Evidence

Cylinder Cupboard

  • Door Size

  • Cupboard Depth, Width & Height

  • Photographic Evidence of Cylinder Cupboard

  • What Size of Cylinder Will Fit

  • How will the Dischage Pipe Route to Outside be done

  • Existing Cylinder Type

Proposed Heat Pump

  • Bracket Type

  • Proposed Location

  • Proposed Location Photo

  • ASHP Soak Away Required

  • Recommendation

  • Pipework Upgrade to 28mm Required? (Daikin Requires 28mm). State length.

  • Trunking Requirements

  • Can the External Unit be Installed 1m from Boundary

  • Recommended Solution

  • How Many Reflective Surfaces

  • Distance to Nearest Habitable Room

  • From Assessment Area What Barrier is in Place

Thermostat

  • Current Thermostat Position

  • Photo of Current Location

  • Proposed Thermostat Position

  • Photo of Proposed Location

Existing Heating

  • How Many Storage Heaters/Radiators Need to be Removed?

  • Storage Heater Serial Number (For Asbestos Purposes)

Room Details

  • Floor Construction Type

  • Floorplan Showing Individual Room Sizes and Ceiling Height

  • Living Room

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Hallway

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Dining Room

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Upper Floor Hallway/Landing

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Bedroom 1

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Bedroom 2

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Bedroom 3

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Bedroom 4

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Bedroom 5

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Study

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Kitchen

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Bathroom

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • W/C

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Other Specify

  • What Room

  • Window Sizes

  • Number of Outside Walls

  • Internal Wall Type

  • Max Space Available for Radiator (Length, Height)

  • Existing Radiator Size

  • Photo

  • Job Requirements

Declarations

Customer Informed

  • LCX Not Responsible for Decorating

  • LCX Not responsible for Carpets

  • LCX Not Responsible for Laminate Flooring and Customer must Remove Prior to Works

  • LCX Not Responsible for Loose Ornaments, Mirrors, Pictures etc. Customer must Remove Prior to Works

  • Customer Informed if Shower is NOT Compatible with ASHP

  • LCX Not Responsible for Shower

Customer Declaration

  • DECLARATION: I understand what what is due to be carried out and I agree to the positions of the pipe-work, radiators, cylinder, external unit and room thermostat.

  • I agree to the use of the welfare facilities in my property

  • Customer Signature

Risk Assessment and Sign Off

Access Assessment

  • Does the main power cable to the property need sheathing before scaffold erected?

  • Photographic Evidence

  • Are there any restrictions to the property i.e. Low bridge, neighbours access required?

  • Comments

  • Photographic Evidence

  • Is the property location a main pedestrian route and/or a public walkway?

  • Comments

  • Photographic evidence

  • Is parking available, adequate for the size of vehicle and close to the property?

  • Comments

  • Photographic evidence

  • Do parking restrictions exist i.e. Residents parking?

  • Comments

  • Photographic evidence

  • Will the proposed works affect neighbouring properties?

  • Comments

  • Photographic evidence

  • Has the neighbouring property been notified of the imminent works?

  • Date of notification given

Asbestos Assessment

  • Are we in receipt of or have access to the asbestos survey or register for this property ?

  • Comments

  • Has asbestos been identified ?

  • Comments

  • Photographic evidence

Assessment Sign off

  • Surveyors Signature and Full name

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