Title Page
Details
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Client
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Who?
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Conducted on
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Prepared by
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Name of Competent Person
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Survey Type
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First Line of Address
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Front Elevation Photo
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Location
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Project
Property Information
Property Details
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Is a Smart Meter Installed
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Has the glazing been upgraded since the PIBI was completed
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Glazing Type
Existing Heating
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How Many Storage Heaters/Radiators have been removed
Mid & Post Install
Cylinder
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Is the cylinder being changed
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Existing Cylinder Removal/Removed Photo
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New Cylinder Type & Installed Photo
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How is the Discharge Pipe Routed to the outside
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Loft Water Tank Removal
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Fuse Board Photo Evidence
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Main Fuse Cut Out Rating Evidence
Rooms in Property
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What rooms are present in the property
- Living Room
- Dining Room
- Hallway
- Bedroom 1
- Bedroom 2
- Bedroom 3
- Bedroom 4
- Bedroom 5
- Study
- Kitchen
- Bathroom
- W/C
- Other
Living Room
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Dining Room
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Bedroom 1
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Bedroom 2
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Bedroom 3
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Bedroom 4
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Bedroom 5
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Kitchen
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Bathroom
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
W/C
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Other
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Specify Room
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Study
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Hallway
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Removed Heater Evidence
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New Heater Fitted
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Type Fitted
Sign Off
Customer Declaration
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Is the resident satisfied with the completed works
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Resident Signature
Assessment Sign off
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Competent Person Signature and Full name
