Quantum Heating Survey v1.0

• Document No.

• Audit Title

• Conducted on

  Date

• Prepared by

CUSTOMER NAME AND ADDRESS

• Insert Date:

  Date

• Contact:

• Address:
  Address

• Telephone:

• Email Address:

SITE DETAILS

• Address:
  Address

TYPE OF PROPERTY

• Insert House Type:

  House

  Bungalow

  Flat

  Other

• Insert Type:

  Detatched

  Semi Detached

  Terraced

• Insert Type:

  Detatched

  Semi Detached

  Terraced

• Insert Type:

  Detatched

  Semi Detached

  Terraced

• Insert Type:

TYPE OF CONSTRUCTION

• Insert Construction Method:

  Select Cavity Wall With Insulation Solid Walls Solid Floor Timber Floor Pitched Roof Flat Roof No Insulation 100mm Insulation 150mm Insulation 200mm Insulation Single Glazed Double Glazed

  • Cavity Wall
  • With Insulation
  • Solid Walls
  • Solid Floor
  • Timber Floor
  • Pitched Roof
  • Flat Roof
  • No Insulation
  • 100mm Insulation
  • 150mm Insulation
  • 200mm Insulation
  • Single Glazed
  • Double Glazed

PRODUCTS SPECIFIED

• Are you interested in Solar Hot Water?

  YES

  NO

• Are you interested in Water Heating?

  YES

  NO

SURVEY RESULTS

• Enter Room

Room

• Room Details:

• Area m2:

• Floor to Ceiling Height:

• External Wall Length:

• Window Area m2:

• External Door Area m2:

• Internal Wall Length to Un Heated Wall:

• Is the Room Heated?

  YES

  NO

• Insert Type and Size of Existing Heater:

• Does this room require heating?

  YES

  NO

• Insert Length of New On Peak Supply:

• Insert Length of New On Peak Supply:

• Roof Above?

  YES

  NO

• Open Fire Place?

  YES

  NO

EXTRA WORKS - In Accordance with Heating System and to Comply With Current Regulations.

• Does the Occupant Require Additional Works?

  YES

  NO

• Insert Extra Works:

EXTRA WORKS - Over and Above Heating System

• Does the Occupant Require Additional Works?

  YES

  NO

• Insert Extra Works:

ADDITIONAL INFORMATION

• Comments:

• Insert Image if Relevant:

  Media