Title Page
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Survey Type
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Site conducted
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Conducted on
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Prepared by
Survey Details
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Survey Date
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Surveyor Name
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Address
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Postcode
Customer Details
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Owner First Name
- Shal
- Abri
- Alliance
- Celtic Horizons
- Exeter City Council
- Stroud
- Dartford Borough Council
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Owner Last Name
- Shal
- Abri
- Alliance
- Celtic Horizons
- Exeter City Council
- Stroud
- Dartford Borough Council
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Owner Contact Number
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Owner Email
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Owner Address
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Resident First Name
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Resident Last Name
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Resident Contact Number
General
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What is the main purpose of this visit?
Property Tenure
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Property Type & Detachment
- Semi Detatched
- terraced
- Detatched
- GF Flat
- Middle flat
- TF Flat
- Bungalow
- coach house
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Property Age Band
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Number of Storeys
Occupancy Details
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Is the occupancy considered typical for the property?
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Is the occupancy due to change within the foreseeable future?
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Is there a thermostat?
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Is the thermostat maintained at a typical temperature?
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Is this due to the thermostat temperature being considered higher or lower than typical?
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Is the heating pattern considered typical for the property?
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Is this due to the heating pattern being considered higher or lower than typical?
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Does the customer utilise all heat emitters within each room that contains them?
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Has the customer been made aware of the process of gathering personal data and relevant Data Protection policies?
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Current Energy Efficiency Measures
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Can you identify any existing Energy Efficiency Measures that have been installed?
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Do you believe that all current Energy Efficiency Measures are being used correctly?
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Current Energy Efficiency Measures
Page 3 of
Advice
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Has the required and appropriate advice been provided to the customer(s)?
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How has advice been provided?
- Verbal
- Leaflet
- web link / QR Code
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Details of the advice that has been provided:
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Condition of External Walls and DPC
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Condition of Roof
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Condition of Windows and Doors
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Condition of Internal Walls
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Condition of Floor Structure
Generated Using CoreLogic UK PAS Assessment and PAS Hub
Ventilation – Habitable Rooms
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Description
Purge Ventilation
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Undercuts
Background Ventilation
Ventilation – Wet Rooms
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Description
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Undercuts
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Extractor Fans
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Have you explained how and why extractor fans should be used?
Ventilation – Internal Wall Insulation
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Is Internal Wall Insulation (or IWI) being installed at the property?
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Can 100% of the measure be insulated with IWI?
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Can 100% of the measure be insulated with a hybrid EWI/IWI solution?
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Is the limitation confined to only wet rooms?
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Can wet rooms be heated to 18°C when the property is occupied?
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Does the property have continuous mechanical requirements of Annex C – Clause 3.5 of PAS
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Has the customer agreed to have continuous accordance with all the requirements of Annex C –Clause 3.5 of PAS 2035:2019?
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Please enter details regarding the instructions and and how this has been provided:
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Ventilation Calculations
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Number of Bedrooms
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Number of Additional Occupants
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Total Floor Area (m2)
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Calculated Ventilation Rate (l/s)
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The minimum calculated number of trickle vents has been calculated based on the total number of taken into consideration for the design and/or ventilation strategy
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Minimum Calculated Number of Trickle Vents
Generated Using CoreLogic UK PAS Assessment and PAS Hub
Page 5 of
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Customer Signature
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Signature Date:
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Surveyor Signature
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Signature Date:
