PAS 2035-19 Cavity Wall Survey (July 2023)

Information

Location.
Client Name.
Contact Details.
Tenure.
- Owner occupier
- Local Authority
- Housing Association
- Privately Rented
- Eco measure
Scheme type.
- Owner occupier
- Local Authority
- Housing Association
- Privately Rented
- Eco measure
Survey conducted by.
Conducted on

Building & Heating Information:

Construction age of the building.
Property Type.
- Mid-Terrace
- End terrace
- Semi-detached
- Detached
- Ground Floor Flat
- Middle Floor Flat
- Top Floor Flat
- Masonette
- Bungalow
- House
- Commercial Building
Number of Bedrooms.
- 1
- 2
- 3
- 4
- 5+
- N/A Commercial
Floor Construction Type
- Solid
- Suspended
- Suspended not wood
- Other
Please take a photo of the front door
Please take a photo of the Electric and Gas meters where applicable.
Main Heating type, plus take a photo of the appliance ID and rating plate.
Photo of appliance name/make/model/rating plate.
Location of the flue, please take a photo.
Secondary heat source, please take a photo.
Secondary Heat source type.
- Gas Fire with Flue
- Gas Fire with chimney
- Gas Fire Flush Fitted
- Open Fire with internal chimney
- Open Fire with external chimney
- Wood Burner
- No other heating present
Please state appliance, fuel type, flue type, location of appliance, size of appliance and ventilation requirements
Location of Chimney if present.
Location of Combustion vent if present.
Will the CWI installation work result in the unsafe operation of a combustion appliance e.g. Flue, Chimney
Take Photos internally and externally of the vent

Cavity Survey Information

Total Area of property
Total area to be insulated.
What is the extent of the cavity to be fill?
Required material.
- Thermabead Carbon Saver
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
Total area to be omitted.
Photos of omitted areas.
Does the building have any air vents.
- Yes
- No
If yes please select.
- Underfloor vents
- Kitchen vents
- Bedroom vents
- Bathroom vents
- Combustion vent
- Extraction fan kitchen
- Extraction fan bathroom
- Pantry vents
- Window trickle vents
Do any of the air vents require sleeving or sealing up before installing the cavities.
Please select the type of ventilation present, including extraction ventilation and trickle vents.
Please take a photo of all background vents and extraction fans fitted within the property including at least two photos of window trickle vents.
- Underfloor vents
- Kitchen vents
- Bedroom vents
- Bathroom vents
- Combustion vent
- Extraction fan kitchen
- Extraction fan bathroom
- Pantry vents
- Window trickle vents
Adjoining properties insulated ?
Number of Cavity brushes required.
Core vent required.
Number of core vents and location.

Front Elevation.

Total area (a)
Area to be omitted (b)
Area to be installed (a-b)
Photo of elevation .
Please take a photo of all gutters or down pipes on this 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
Take Photo showing tape in cavity showing depth
Photo of Borescope in wall
Borescope Photos.
Please take a photo of the DPC, if not visible take an internal photo using Borescope
Is Internal drilling required, if yes provide notes and photos of the area
Comments

Rear Elevation

Total Area (a)
Area to be omitted (b)
Area to be installed (a-b)
Photo of elevation
Please take a photo of all gutters or down pipes on this 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 Borescope in wall
Borescope Photos.
Take Photo showing tape in cavity showing depth
Please take a photo of the DPC, if not visible take an internal photo using Borescope
Is Internal drilling required, if yes provide notes and photos of the area
Comments

Right hand elevation

Total Area (a)
Area to be omitted (b)
Area to be installed (a-b)
Photo of elevation
Please take a photo of all gutters or down pipes on this 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
Take Photo showing tape in cavity showing depth
Photo of Borescope in wall
Borescope Photos.
Please take a photo of the DPC, if not visible take an internal photo using Borescope
Is Internal drilling required, if yes provide notes and photos of the area
Comments

Left hand elevation

Total Area (a)
Area to be omitted (b)
Area to be installed (a-b)
Photo of elevation
Please take a photo of all gutters or down pipes on this 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
Take Photo showing tape in cavity showing depth
Photo of Borescope in wall
Borescope Photos.
Please take a photo of the DPC, if not visible take an internal photo using Borescope
Is Internal drilling required, if yes provide notes and photos of the area
Comments

Building extensions

Total area (a)
Area to be omitted (b)
Area to be installed (a-b)
Photo of elevation
Please take a photo of all gutters or down pipes on this 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
Take Photo showing tape in cavity showing depth
Boroscope Photos.
Please take a photo of the DPC externally, if covered and not visible take an internal photo using Borescope
Is Internal drilling required, if yes provide notes and photos of the area
Comments

Construction details and Condition:

Building Finish plus photos of all the elevations of the property.
Type & Condition of the Building structure suitable for the work to commence?
External Condition of the building.
- Very good
- Good
- Poor
- Very poor
Is the property suitable to receive the insulation type specified?(Construction type, Exposer, Condition of Structure)
Please take photo’s of plants or Ivy attached to property, please note these will need to be removed if they are attached to the building.
Have you informed the client that the plants or Ivy will need to be removed.
Have you done an internal inspection of the building? If yes please take photos of your findings.
If you have answered yes please select the best description of your findings.
- 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.
Safety monitors present.
- Smoke Alarm
- Fire Alarm
- CO2 Alarm
Protected species or rodents present in building.
Special Instructions.

Access

On site parking.
Client Instructions.
Will the site layout or condition impair the execution of the work?
Access Equipment Required.
- None
- Ladders
- Scaffold Board for Flat Roof
- Scaffolding
- Conservatory Ladder
- Roof Ladder
If scaffolding required will it be supplied by the customer?

Cavity Wall Insulation

Additional Photos

Loft Hatch
Left Gable Wall from inside loft
Right Gable Wall From inside Loft
Party Wall from inside Loft
Photo of wall being measured windows (show both ends of tape)
Close up brick pattern & mortar joints

PAS Questions

Will the CWI installation work result in non compliance with building regulations e.g. Workmanship, Materials
Will the CWI installation work result in compromise to the functionality of the existing ventilation ducts/systems
Will the CWI installation work result in compromise to the functionality and/or safety of the existing services
Will the CWI installation work result in the installation that is Non-compliant materials suppliers requirements
Property drilled to establish clear cavity width
All areas NOT to be insulated are agreed with the customer
Any areas to be insulated vie the internal leaf agreed with the customer
Is there any potential for moisture build upas a result of the installation?
Will the functionality and/or safety of installed services (gas,electricity,water, telecommunications etc.) be affected in any way as a result of the installation?
Is there any potential risk in relation to the ongoing performance of the installed services?
From the findings of the survey, is the installation able to be carried out in line with the full design specification
From the finding of the survey, is the method statement suitable and complete?
Does the customer understand the nature and extent of the work?
Have they been made aware of any disruption that may be caused (for example rubbish disposal and the siting of skips)

Dynamic Risk assessment CWI.

If Cavity please do a risk assessment.
Use of a ladder/step ladder.
Noise.
Vibration.
Manual Handing.
Hand Tools/Power Tools
Compressed air.
Electricity/Generator
House keeping/site tidiness.
Working with with wet cement,concrete or mortar.
Overhead cables.
Reversing a vehicle.
Asbestos.
Use of a Mobile tower/MEWP
Lone Worker.

Installation Checks CWI. (To be completed by cavity technician at install)

If cavity install please select;
Crew Leader.
No.2
Date:
Cavity width(mm)
Gables Installed:
Jet Size used:
Core vent fitted?
Pipe 1 Glue flow (ml) Bead Flow (kg)
Pipe 2 Glue flow (ml) Bead Flow (kg)
Number of barrier brushes fitted?
Number of vents replaced.
We're pre installation checks carried Out?
We're post installation checks carried Out?
Crew Signature:
Customer Signature:

Loft Insulation.

The current depth of loft insulation is sufficient please provide a few photos below.
Please select if loft survey:
Loft hatch size.
Photo of loft access.
Area to be Insulated.
Existing depth.
- 0mm
- 12mm
- 25mm
- 50mm
- 70mm
- 80mm
- 100mm
- 125mm
- 150mm
- 200mm
- 250mm
- 270mm
- 300mm plus
Please take a photo of the existing insulation depth.
Depth to be added.
- 100mm
- 150mm
- 200mm
- 250mm
- 270mm
- 300mm
Loft Height at Centre?
- 0.80 metres
- 0.90 metres
- 1.00 metres
- 1.20 metres
- 1.40 metres
- 1.50 metres
- 1.60 metres
- 1.80 metres and above.
In your opinion should the loft be Rolled or Blow?
Please draw the loft area, marking the hatch, pipes, tanks and combustion flue.
Pipes and tanks present.
Details of Pipes and tanks to be insulated.
Spot lights present in ceiling?
Details of the number of spot lights and the rooms they are fitted in.
Electrical wiring free from visual defects?
Does a combustion flue pass through the loft space?
Relay Required?
Loft hatch need D/P installing?
Poly wedges required?
Area to be omitted?
Walkway required.
Walkway details length, position.
Loft clearance required.
Details of loft clearance.

Dynamic Risk assessment Loft.

Please select if Loft.
Use of a Step ladder/ladder
Access and Egress
Manual Handing
Hand Tools/Power Tools
Vibration
Noise
Dust
House Keeping
Lone Working
I have assessed the condition 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.
Please provide details if you have answer no.
Customer Signature: