Title Page

  • Client

  • Who?

  • Conducted on

  • Survey Type

  • Prepared by

  • Name of Competent Person

  • First Line of Address

  • Front Elevation Photo

  • Location
  • Project

Health & Safety

Health & Safety Questions

  • Is this the only energy efficiency measure for this property

  • You must complete the following questions

Access Assessment

  • Do you give consent for us to carry out works within your property?

  • Reasoning?

  • Resident Full Name and Signature

  • Is there an overhead main power cable to the property that needs sheathing before scaffold erected?

  • Photographic Evidence

  • Are there any conservatories or out buildings that require a scaffold bridge for this job?

  • Are there any restrictions to the property i.e. Low bridge, neighbours access required?

  • Comments

  • Photographic evidence

  • Does the property have a main pedestrian route or a public walkway directly on one of the elevations?

  • Comments

  • Photographic evidence

  • Is there adequate parking close to the property?

  • Comments,

  • Photographic evidence

  • Any parking restrictions i.e. Residents parking?

  • Comments

  • Photographic evidence

  • Will the proposed works affect neighbouring properties?

  • Comments

  • Photographic evidence

  • Has the neighbouring property been notified of the imminent works?

  • Date of notification given-

Occupant Assessment

  • Is the property in a suitable condition for the proposed works to be carried out?

  • Comments

  • Photographic evidence

  • Is the property highlighted as flagged or at risk?

  • Comments

  • Do the occupants have any physical disabilities that pose any significant risks?

  • Comments

  • Do the occupants have any learning difficulties or mental health issues where our activities may pose any significant risks?

  • Comments

  • Are there any potential risks regarding minors in the property?

  • Comments

  • Are there any potential risks regarding pets in the property?

  • Comments

  • Is there any presence of protected species (e.g., bats, birds butterflies, dormice) or plants that could be subject to special protection?

  • Comments

  • Is the property high risk of biological waste or vermin?

  • Comments

  • Photographic evidence

  • Does the resident use hypodermic needles?

  • Where is the sharps bin located/comments

Asbestos Assessment

  • Are we in receipt of or have access to the asbestos survey or register for this property ?

  • Asbestos Assessment Needs to be Checked

  • Comments

  • Has asbestos been identified ?

  • Comments

  • Photographic evidence

  • Have the health and safety questions been completed on another survey

  • You may proceed to the next page

  • This health and safety section must be completed

Access Assessment

  • Do you give consent for us to carry out works within your property?

  • Reasoning?

  • Resident Full Name and Signature

  • Is there an overhead main power cable to the property that needs sheathing before scaffold erected?

  • Photographic Evidence

  • Are there any conservatories or out buildings that require a scaffold bridge for this job?

  • Are there any restrictions to the property i.e. Low bridge, neighbours access required?

  • Comments

  • Photographic evidence

  • Does the property have a main pedestrian route or a public walkway directly on one of the elevations?

  • Comments

  • Photographic evidence

  • Is there adequate parking close to the property?

  • Comments,

  • Photographic evidence

  • Any parking restrictions i.e. Residents parking?

  • Comments

  • Photographic evidence

  • Will the proposed works affect neighbouring properties?

  • Comments

  • Photographic evidence

  • Has the neighbouring property been notified of the imminent works?

  • Date of notification given-

Occupant Assessment

  • Is the property in a suitable condition for the proposed works to be carried out?

  • Comments

  • Photographic evidence

  • Is the property highlighted as flagged or at risk?

  • Comments

  • Do the occupants have any physical disabilities that pose any significant risks?

  • Comments

  • Do the occupants have any learning difficulties or mental health issues where our activities may pose any significant risks?

  • Comments

  • Are there any potential risks regarding minors in the property?

  • Comments

  • Are there any potential risks regarding pets in the property?

  • Comments

  • Is there any presence of protected species (e.g., bats, birds butterflies, dormice) or plants that could be subject to special protection?

  • Comments

  • Is the property high risk of biological waste or vermin?

  • Comments

  • Photographic evidence

  • Does the resident use hypodermic needles?

  • Where is the sharps bin located/comments

Asbestos Assessment

  • Are we in receipt of or have access to the asbestos survey or register for this property ?

  • Asbestos Assessment Needs to be Checked

  • Comments

  • Has asbestos been identified ?

  • Comments

  • Photographic evidence

PV Survey

PV Survey

Supplier & MPAN

  • Current Energy Supplier

  • Which Supplier?

  • Electricity Tariff Information

  • What is the tariff name?

  • On Peak Day Rate (pence per kWh)

  • Is it a dual rate meter?

  • Off Peak Night Rate (pence per kWh)

  • Is the MPAN Number Present

  • What is the MPAN Number

Roof Type

  • Roof Style

  • Tile Type

  • Tile Description (clay or concrete, interlocking or lapped)

Roofing and Scaffold

  • Scaffold Location

  • Height of Eaves? (Metres)

  • Required Access to rear?

  • Location of rear access

  • Where?

  • Length along the gutter (Metres)

  • Height up the roof slope (Metres)

  • Pitch ° degrees

  • Height of Roof Above Eaves? (Metres)

  • Front of Property Orientation in ° Degrees

  • Is the Loft Accessible?

  • Roof type

  • Size of Purlin (mm)

  • Number of Purlin Supports Front

  • Number of Purlin Supports Back

  • Number of Purlin Supports Side

  • Maximum Unsupported Rafter Length (Metres)

  • Size of Rafters/Top Chord of Truss (mm)

  • Number of Trusses/Rafters

  • Rafter/Truss Centres (mm)

  • Timber Condtion

  • Felt Condition

  • Observations (e.g holes in felt around gas flue)

  • Loft Condition

  • Is the inverter to be fitted in the loft space?

  • Is There a Smoke Detector in the Loft

  • New Smoke Detector to be Fitted in Loft

  • What is the Make and Model

  • Does it Need Replacing With Client Specified Model

  • Any Issues With Loft access

  • What Issues?

  • Loft Headroom Meters

  • Temporary Loft Light Required

  • Temporary Loft Walkway Required

  • Why?

  • Notes

Electrics

Consumer Unit

  • Consumer Unit Make and Model

  • What Brand?

  • Location

  • Where?

  • Breaker Type

  • Consumer Unit Visually Compliant?

  • Distribution Board Upgrade / Garage DB Required

  • Spare Way for PV

  • Additional Garage DB Required for PV

  • Earthing to Gas Meter

  • Gas Meter Location

  • Where?

  • Earthing to Water Main

  • Water Main Location

  • Where?

  • Earthing Type

Import Meter Type

  • Meter Type

  • Does Meter require changing?

  • Make and Model of Meter

  • What Model?

  • Meter Serial Number

  • Is there room for the 4 pole isolation switch next to the existing meter

  • Import Meter Location

  • Where is it?

  • Generation Meter Location (Proposed)

  • Where shoud it be located?

Photovoltaic System Proposed

  • Recommended Proposed Inverter Location

  • Where should is be located?

  • Can a 600 x 780 board fit on wall and through internal roof access

  • Approx AC cable run length from Consumer Unit to Inverter

  • Is a PV Diverter Required? (Eddi)

  • Will there be Battery Storage

  • Size of Proposed Area

  • Distance to DB

  • Proposed Battery Location

  • Photo of Proposed Location

  • Is Bird Mesh a Recommendation?

Photo Checklist

  • Property Elevations & Scaffold Access

  • Suitable Roof Elevation Close Up inc gutter

  • Proposed Inverter Location

  • Loft Access and Roof Void

  • Consumer Unit and Close up of Breakers

  • Electricity Meter & Mains Fuse / Earth in Meter Box

  • Water Main Bond

  • Gas Main Bond (if applicable)

  • Satellite Dish (if any) including closeup of bracket

Shading Considerations

  • Is a shading assessment required?

  • Why?

  • Notes

EEM Specific Survey Information

EEM Information

  • Have relevant checks been undertaken to determine if asbestos containing materials are present

  • Are the arrangements made for site access and installation materials storage adequate and appropriate for the installation to be undertaken

  • Is the nature and extent of the survey known to the customer and is it in line with their expectations

  • The installation work will not result in a non-compliance with the building regulations in relation to:

  • Workmanship

  • Materials

  • Structural Stability

  • Fire Safety

  • Resistance to Moisture

  • Any avoidable thermal bridging

  • Any unsafe operation of combustion appliances

  • Functionality of existing ventilation ducts/systems

  • Runctionality and/or safety of existing services (gas, electric, water, telephone, etc.)

  • Any requirements stated by the supplier

Sign Off

Assessment Sign off

  • Competent Person Signature and Full name

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.