Title Page

  • Survey Type

  • Site conducted

  • Conducted on

  • Prepared by

Survey Details

  • Survey Date

  • Surveyor Name

  • Address

Customer Details

  • HA Name

  • Resident Name

  • Resident Contact Number

  • Resident email

General

Property Tenure

  • Property Type & Detachment

  • Property Age Band

  • Number of Storeys

Occupancy Details

  • Is the occupancy considered typical for 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?

  • Current Energy Efficiency Measures

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

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

  • Current Energy Efficiency Measures

Generated Using CoreLogic UK PAS Assessment and PAS Hub

  • Has the required and appropriate advice been<br>provided to the customer(s)?

  • How has advice been provided?

  • Condition

  • Condition of External Walls and DPC

  • Condition of Roof

  • Condition of Windows and Doors

  • Condition of Internal Walls

  • Condition of Floor Structure

  • Is there penetrative and/or rising damp present at the property?

  • Is there evidence of condensation and/or mould growth in the dwelling?

Ventilation – Habitable Rooms

  • Is there an existing ventilation system?

  • Is the existing ventilation system complete and<br>functional?

  • Type of ventilation system that is present

  • Description

Purge Ventilation

  • Undercuts

Background Ventilation

Ventilation – Wet Rooms

  • Description

  • Undercuts

  • Extractor Fans

  • Have you explained how and why extractor fans should be used?

Ventilation – Internal Wall Insulation

  • Is Internal Wall Insulation (or IWI) being installed at the property?

  • Can 100% of the measure be insulated with IWI?

  • Can 100% of the measure be insulated with a hybrid EWI/IWI solution?

  • Is the limitation confined to only wet rooms?

  • Can wet rooms be heated to 18°C when the property is occupied?

  • Does the property have continuous mechanical requirements of Annex C – Clause 3.5 of PAS

  • Has the customer agreed to have continuous accordance with all the requirements of Annex C –Clause 3.5 of PAS 2035:2019?

  • Please enter details regarding the instructions and and how this has been provided:

  • Ventilation Calculations

  • Number of Bedrooms

  • Number of Additional Occupants

  • Total Floor Area (m2)

  • Calculated Ventilation Rate (l/s)

  • 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

  • Minimum Calculated Number of Trickle Vents

Generated Using CoreLogic UK PAS Assessment and PAS Hub

Page 5 of

  • Customer Signature

  • Signature Date:

  • Surveyor Signature

  • Signature Date:

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