Title Page
-
Document No.
-
Client / Site
-
Address
-
Conducted on
-
Prepared by
-
CRM Number
-
Job number (warm works only)
Customer Details
Client Details
-
Title
- Mr
- Miss
- Mrs
- Ms
- Dr
- other
-
If other please specify
-
Forename
-
Surname
-
Mobile No
-
Landline No
-
Email
-
Preferred method of contact
-
Tenure
-
Written Permission Received
-
If other please specify
Property Details
Property Details
-
Wall Construction
-
Property Age
-
Property Type
- Detached
- Semi Detached
- Mid Terrace
- End Terrace
- Semi Det Bungalow
- Det Bungalow
- Flat
-
Number of Bedrooms
-
Fuel Type
-
Ventilation
-
DPC Level Details
-
Pull Out Test (Fixings used will comply with system specification and will achieve pull test requirements. Tests will be provided but May be upon completion as tests are carried out by a third party. Please process the warrant on the basis that we will achieve the requirements).
-
Access Issues
-
Make and model of boiler
-
Are there any CO or other safety Alarms? if so are they operational?
-
Protected Species
-
Front Elevation
-
Rear Elevation
-
Right Hand Gable
-
Left Hand Gable
Install Survey
Install Survey
-
System Specified
-
Agreed Finish
-
Statutory Warrants Required?
-
Area to be insulated
-
Percentage of area being insulated
-
Overcill Colour
-
Location of fire breaks
Enabling Measures
-
Gas Pipe Extension
-
Mains Power
-
Core/Floor Vent
-
Traffic Management
-
Flue Extension
-
Scaffolding
-
BT Cable
-
Sky Dish/Tv Aerial
-
Outdoor Tap
-
Outdoor Light Socket
-
Cable TV
-
Alarm Box
-
Cast Pipes
-
Plastic Pipes
-
Soil Vents Pipes
-
Gates
-
Fence
-
Overcills
Site Notes
Site Notes
-
Customer Requirements, Expectation and/or Special Needs
-
Variation to system required?
-
Agreed Customer Attendances (Welfare, Access, Storage, Remedial Works, Neighbours Permission, Enabling works
-
Additional Works Agreed by Customer
-
Damage or Defects Noted at Survey Stage
-
Relevant Disclaimers
-
Project Specific notes
Sign Off
Sign Off
-
By ticking this box you are confirming your acceptance of the issues, actions and spec agreed above. And For you to allow Richard Irvin Energy Solutions to carry out the Measure at no cost to you.
-
You have been made aware of the scope of works to be done and have been made aware of any risks involved.
-
Customer Signature
-
Surveyors Signature
-
Additional Notes