Title Page
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Date survey was conducted
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Customer name
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Survey done by
- Steve Clark
- Ralph Medcalf
- Lewis Williams
- Mark Conway
- David Mosscrop
- Other
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Please Enter Your Name:
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Location
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Is there parking available on site?
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If possible, please add location of nearest available location to park
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Were Toll Roads or Crossings used to get to this site?
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Please give details:
Washroom Survey
- WASHROOM
Propelair Washroom Survey Report Site-based information.
Section 1: Information on washroom whereabouts inside the building
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1. What floor level is it located on?
- Basement
- Ground
- 1st
- 2nd
- 3rd
- 4th
- Other
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2. Type of washroom
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3. Number of toilets
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4. Please measure the literage of 1 flush. To do this, disconnect the water supply from the cistern to the toilet, and flush the cistern into a bucket. This is more accurate than measuring the max-min water levels within the cistern, as it takes the pouring water (which is immediately syphoned into the toilet) into account.
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5. It is normal to install flush counters during the site survey. Are these being installed?
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Why not?
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How many are being installed?
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When will the counter readings be next read?
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Who is going to take the counter readings?
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6. Please take a photos of the washroom.
Section 2: Installation and the void
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7. How big is the gap between the back wall of the cubicle and the centre of the door swing (in mm)?
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Take photos if needed
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8. Is there IPS panelling?
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What is the panelling made of?
- MDF
- Glass Reinforced Plastic
- Metal
- MDF & Metal
- GRP & Metal
- Other
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Is the IPS panelling full or half height?
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Will blanking off plates be required?
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Please give details of size, shape and colour required
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How many blanking plates are required
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Take a photo if required
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Will custom built boxing required?
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Please take measurements and photos
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9. What is the depth of the void, from the back wall to the front of the IPS Panel
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10. What is the thickness of the divide between the cubicle where the pan is and the void where the cistern will be located (in mm)
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11. Will the cisterns be Standard or Reverse mounted?
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12. Are there any obstructions for mounting the new cistern?
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13. Will standard length (500mm) water hoses be long enough?
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Will 750mm hoses be long enough?
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14. Are 90 degree water hose cuffs required to lower the cistern?
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How many are required?
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15. Are there any obstacles within the void that will make it extremely difficult/not possible to install any part of the Propelair system?
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Please give details
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Please take photos
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16. What size is the water supply:
- 15mm Copper
- 22mm Copper
- 28mm Copper
- Other
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Please give details
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Please take photos
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17. Where does the water supply come from?
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Please give details
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Please add any additional photos relating to this section.
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Please add any additional information relating to this section.
Section 3: Drainage (soil pipe and sewerage)
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18. Is the soil pipe below ground level?
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19. What is the material of the waste pipe?
- Plastic
- Cast Iron
- Clay / earthenware
- Fusion Welded Thermo-Plastic
- Copper
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20. What is the soil spigot type (select multiple answers if required)?
- 90 degree bend
- 45 degree bend
- 92 degree tee
- Pan connects into floor with Multi-quick fitting
- Unable to see
- Straight connection through wall
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21. What is the height of the waste outlet? (mm)
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22. Will any of the toilets require a 40mm plinth to raise the pan?
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How many are required?
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23. Is there enough space to install latest spec venting
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24. Is there a vertical stack vented to atmosphere
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25. Does the washroom have an external wall
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How thick is the wall in mm
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How far is the nearest external wall in metres (approximately)
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26. Is there a rodding access
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27. Does the washroom have a drainage inspection chamber within it?
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Please locate the nearest inspection chamber and give details of it's location and the type of drain key required to open it.
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Please take a photo
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28. Is existing waste installed in a way that promotes crossflow?
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Please state what is required to correct this.
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29. How many non-return valves are required for the secondary overflow?
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30. Are additional non-return valves required? (Basins, urinals)
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Please state how many and what sizes
Section 4: Additional information for this washroom.
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31. Does the washroom have removable ceiling tiles?
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32. Does the washroom use paper towels for hand drying?
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33. Does the washroom have single sheet toilet roll dispensers?
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34. Details of electrical supply present
- None
- Existing appliances only
- Current toilets have a power supply for flush mechanism
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35. Is there an inspection chamber inside the washroom?
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Is there an inspection close-by outside the washroom?
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Please enter any additional notes on the installation.
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Please add any additional sketches as appropriate.
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Take any additional photos as required.
Section 5: Site-level notes and completion (only once per site NOT per washroom).
Health and safety considerations
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Generic site risks:
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Specific locale risks:
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Hazardous conditions:
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Hazardous materials:
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Environmental risks:
Any additional comments, sketches, or photographs:
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Comments:
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Sketches:
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Photographs:
Names and signatures:
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Surveyor name:
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Surveyor signature:
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Client representative name:
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Client representative email:
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Client representative signature:
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Time and date stamp:
