Low Carbon Exchange Ltd Property Survey. - duplicate

• Client Name.

• Contact Details.

• Location.
  Address

• Tenure.

  Select Owner occupier Local Authority Housing Association Privately Rated

  • Owner occupier
  • Local Authority
  • Housing Association
  • Privately Rated

• Scheme type.

  Select CERO CSCO CSCO Rural PRIVATE Local Authority Housing Association

  • CERO
  • CSCO
  • CSCO Rural
  • PRIVATE
  • Local Authority
  • Housing Association

• Survey conducted by.

  Alister Paisley

  Paul Eastwood

  Vinnie Stokes

• Is An EPC Required?

  Yes

  No

  N/A

• Has An EPC been carried out ?

  Yes

  No

  N/A

• Type of Survey

  Cavity Wall Insulation

  Loft Insulation

  CWI and Loft Insulation

• Property Type.

  Select Mid-Terrace End terrace Semi-detached Detached Ground Floor Flat Middle Floor Flat Top Floor Flat Masonette Bungalow House Commercial Building

  • Mid-Terrace
  • End terrace
  • Semi-detached
  • Detached
  • Ground Floor Flat
  • Middle Floor Flat
  • Top Floor Flat
  • Masonette
  • Bungalow
  • House
  • Commercial Building

• Construction age of the building.

• Floor Construction Type

  Select Solid Suspended Suspended not wood Other

  • Solid
  • Suspended
  • Suspended not wood
  • Other

• Number of Bedrooms.

  Select 1 2 3 4 5+ N/A Commercial

  • 1
  • 2
  • 3
  • 4
  • 5+
  • N/A Commercial

• Heating Type?

  Select Gas Oil Solid Fuel Electric Other

  • Gas
  • Oil
  • Solid Fuel
  • Electric
  • Other

• Secondary Heat source.

  Select Gas Fire with Flue Gas Fire with chimney Gas Fire Flush Fitted Open Fire with internal chimney Open Fire with external chimney Wood Burner

  • Gas Fire with Flue
  • Gas Fire with chimney
  • Gas Fire Flush Fitted
  • Open Fire with internal chimney
  • Open Fire with external chimney
  • Wood Burner

• Building Finish.

  Select Brick Painted Render Brick/Render Pebble Dash Recon Stone Spar

  • Brick
  • Painted Render
  • Brick/Render
  • Pebble Dash
  • Recon Stone
  • Spar

• Structural Condition.

  Select Very good Good Poor Very poor

  • Very good
  • Good
  • Poor
  • Very poor

• External Condition of the building.

  Select Very good Good Poor Very poor

  • Very good
  • Good
  • Poor
  • Very poor

• Remedial Works Required.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• If yes please give details of remedial work required plus photos.

  Yes

  No

  N/A

• Have you do an internal inspection of the building.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• If you have answered yes please select the best description of your findings.

  Select Low level damp near the skirting boards Black mould in the corners of the rooms Black mould on the ceiling and the walls Condensation on the windows and external walls No internal issues that I can see.

  • Low level damp near the skirting boards
  • Black mould in the corners of the rooms
  • Black mould on the ceiling and the walls
  • Condensation on the windows and external walls
  • No internal issues that I can see.

• Please take photos of your internal findings.

  Media

• Safety monitors present.

  Select Smoke Alarm Fire Alarm CO2 Alarm

  • Smoke Alarm
  • Fire Alarm
  • CO2 Alarm

• Have the alarms all been tested by surveyor.

• Protected species or rodents present in building.

  Yes

  No

  N/A

• Special Instructions.

Access

• On site parking.

• Client Instructions.

• Access Issues.

  Yes

  No

  N/A

• Access Equipment Required.

  Select None Ladders Scaffold Board for Flat Roof Scaffolding Conservatory Ladder Roof Ladder

  • None
  • Ladders
  • Scaffold Board for Flat Roof
  • Scaffolding
  • Conservatory Ladder
  • Roof Ladder

Details

• Total area to be insulated.

• Required material.

  Select Thermabead White Thermabead Carbon

  • Thermabead White
  • Thermabead Carbon

• Average Cavity Depth.

  Select 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

  • 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

• Total area to be omitted.

• Photos of omitted areas.

  Media

• Does the building have any air vents.

  Select Yes No

  • Yes
  • No

• If yes please select.

  Select Underfloor vents Kitchen vents Bedroom vents Bathroom vents Combustion vent

  • Underfloor vents
  • Kitchen vents
  • Bedroom vents
  • Bathroom vents
  • Combustion vent

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

  Yes

  No

  N/A

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

  Select Underfloor vents Kitchen vents Bedroom vents Bathroom vents Combustion vent

  • Underfloor vents
  • Kitchen vents
  • Bedroom vents
  • Bathroom vents
  • Combustion vent

• Adjoining properties insulated ?

  Yes

  No

  N/A

• Number of Cavity brushes required.

• Core vent required.

  Yes

  No

  N/A

• Number of core vents and location.

• Location of chimneys.

  Select Internal External Front Elevation Rear Elevation Left Hand Elevation Right Hand Elevation None

  • Internal
  • External
  • Front Elevation
  • Rear Elevation
  • Left Hand Elevation
  • Right Hand Elevation
  • None

• Location of flue.

  Select Internal External Front Elevation Rear Elevation Left Hand Elevation Right Hand Elevation None

  • Internal
  • External
  • Front Elevation
  • Rear Elevation
  • Left Hand Elevation
  • Right Hand Elevation
  • None

Front Elevation.

• Cavity Depth.

  Select 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

  • 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

• Add drawing

  Drawing

• Photo of elevation .

  Media

• Please mark the position of the Boroscope hole with an S on the elevation drawing.

  Yes

• Boroscope Photos.

  Media

• Comments

Rear Elevation

• Cavity Depth

  Select 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

  • 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

• Add drawing

  Drawing

• Photo of elevation

  Media

• Please mark the position of the Boroscope hole with an S on the elevation drawing.

  Yes

• Boroscope Photos.

  Media

• Comments

Right hand elevation

• Cavity Depth

  Select 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

  • 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

• Add drawing

  Drawing

• Photo of elevation

  Media

• Please mark the position of the Boroscope hole with an S on the elevation drawing.

  Yes

• Boroscope Photos.

  Media

• Comments

Left hand elevation

• Cavity Depth

  Select 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

  • 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

• Add drawing

  Drawing

• Photo of elevation

  Media

• Please mark the position of the Boroscope hole with an S on the elevation drawing.

  Yes

• Boroscope Photos.

  Media

• Comments

Building extensions

• Cavity Depth

  Select 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

  • 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

• Add drawing

  Drawing

• Photo of elevation

  Media

• Please mark the position of the Boroscope hole with an S on the elevation drawing.

  Yes

• Boroscope Photos.

  Media

• Comments

Loft Insulation.

• Is loft to be insulated.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Photo of loft and access point

  Media

• Area to be insulated.

• Existing Depth.

  Select 0mm 12mm 25mm 50mm 70mm 80mm 100mm 125mm 150mm 200mm 250mm 270mm 300mm plus

  • 0mm
  • 12mm
  • 25mm
  • 50mm
  • 70mm
  • 80mm
  • 100mm
  • 125mm
  • 150mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm plus

• Photo of existing depth.

  Media

• Depth to be added.

  Select 100mm 150mm 200mm 250mm 270mm 300mm

  • 100mm
  • 150mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm

• Pipes and Tanks Present

  Yes

  No

  N/A

• Details of Pipes and Tanks to be insulated

• Yes

  No

  N/A

• Spot lights present in ceiling?

  Yes

  No

  N/A

• Details of spot lights

• Electrical wiring free from visual defects?

  Yes

  No

  N/A

• Loft Hatch Size?

• Loft Area.

  Drawing

• In your opinion should loft be Rolled or Blown?

  Rolled

  Blown

• Loft Height at Centre

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Relay Required

  Yes

  No

  N/A

• Loft hatch needing D/P

  Yes

  No

  N/A

• Loft vents required

  Yes

  No

  N/A

• Areas to be omitted

  Yes

  No

  N/A

• Walkway required

  Yes

  No

  N/A

• Details of walkway

• Loft clearance

  Yes

  No

  N/A

• Details of loft clearance

• Additional notes

Dynamic Risk Assessment.

• Reversing vehicle.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Asbestos

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Overhead electricity cables.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Use of a step ladders.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Use of a ladder.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Use of a mobile tower.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Manual Handling.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Working on a roof.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Hand tools.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Vibration.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Noise.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Electricity/Gennerator

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Compressed air.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• House keeping.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Installation of cavity wall.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Working with wet cement, concrete and mortar.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Use of mobile elevation working platform (mewp).

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Lone worker.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• 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.

  None

  See Below

• Assessors signature

  Sign

• Clients Signature

  Sign