Ridgewater Energy Ltd - Insulation Survey

• Client Name.

• Contact Phone

• Contact Email

• First Line of Address

• Location.
  Address

• What-3-Words Location - www.what3words.com

• Tenure.

  Select Owner occupier Local Authority Housing Association Privately Rented

  • Owner occupier
  • Local Authority
  • Housing Association
  • Privately Rented

• Scheme type.

  Select PRIVATE ECO/GBIS - LA FLEX Health Homes Dorset COMF/COLA WH:LG

  • PRIVATE
  • ECO/GBIS - LA FLEX
  • Health Homes Dorset
  • COMF/COLA
  • WH:LG

• Survey conducted by.

  Select STEVE BRIGHT -- (Level 3 DEA) (Level 3 Retrofit Assessor + Traditional Build) (Level 5 Retrofit Coordination & Risk Management) PETER BYWATER JOHNNY FOX -- (Level 3 DEA) (Level 3 Retrofit Assessor + Traditional Build) CHRIS DENMAN -- (Level 2 Introduction to Domestic Retrofit)

  • STEVE BRIGHT -- (Level 3 DEA) (Level 3 Retrofit Assessor + Traditional Build) (Level 5 Retrofit Coordination & Risk Management)
  • PETER BYWATER
  • JOHNNY FOX -- (Level 3 DEA) (Level 3 Retrofit Assessor + Traditional Build)
  • CHRIS DENMAN -- (Level 2 Introduction to Domestic Retrofit)

• Conducted on

  Date

• Type of Survey

  Cavity Wall Insulation

  Loft Insulation

  Cavity Wall & Loft

  Under Floor Insulation

• Construction age of the building.

  Select Before 1900 1900-1929 1930-1949 1950-1966 1967-1975 1976-1982 1983-1990 1991-1995 1996-2002 2003-2006 2007-2011 2012 onwards

  • Before 1900
  • 1900-1929
  • 1930-1949
  • 1950-1966
  • 1967-1975
  • 1976-1982
  • 1983-1990
  • 1991-1995
  • 1996-2002
  • 2003-2006
  • 2007-2011
  • 2012 onwards

• Property Type.

  Select Mid-Terrace End terrace Semi-detached Detached Ground Floor Flat Middle Floor Flat Top Floor Flat Masonette Bungalow House Commercial Building

  • Mid-Terrace
  • End terrace
  • Semi-detached
  • Detached
  • Ground Floor Flat
  • Middle Floor Flat
  • Top Floor Flat
  • Masonette
  • Bungalow
  • House
  • Commercial Building

• Number of Bedrooms.

• Is there a Loft Present

  Yes

  No

  N/A

• Photo of Loft Hatch

  Media

• Floor Construction Type

  Select Solid Suspended Suspended not wood Other Solid & Suspended (mix)

  • Solid
  • Suspended
  • Suspended not wood
  • Other
  • Solid & Suspended (mix)

• Main Heating Type

  Select Mains Gas Oil/Solid Fuel Electric Renewable Technology/Other None LPG GAS

  • Mains Gas
  • Oil/Solid Fuel
  • Electric
  • Renewable Technology/Other
  • None
  • LPG GAS

• Main Heating Photo including Appliance ID and Rating Plate

  Media

• Location of the flue,

  Internal

  External

  Front/Rear

  LHS/RHS

  None

• Photo Of Flue

  Media

• Gas Meter/Electric Meter (optional)

  Media

• Secondary heat source, please take a photo.

  Yes

  No

  N/A

• Secondary Heat source type.

  Select Gas Fire with Flue Gas Fire with chimney Gas Fire Flush Fitted Open Fire with internal chimney Open Fire with external chimney Wood Burner No other heating present

  • Gas Fire with Flue
  • Gas Fire with chimney
  • Gas Fire Flush Fitted
  • Open Fire with internal chimney
  • Open Fire with external chimney
  • Wood Burner
  • No other heating present

• Is a Combustion Vent required for Secondary Heating. (CWI Only)

  Yes

  No

  N/A

• Location of Chimney if present.

  Internal

  External

  Front/Rear

  LHS/RHS

  None

• Location of Combustion vent if present.

  Internal

  External

  Front/Rear

  LHS/RHS

  None

• Building Finish

  Select Brick Brick/Render Painted Render recon Stone/Sand Stone Pebble Dash/Spar

  • Brick
  • Brick/Render
  • Painted Render
  • recon Stone/Sand Stone
  • Pebble Dash/Spar

• Photo of each Elevation and Front Door

  Media

• Building Location Image

  Media

• Structural Condition.

  Select Very good Good Fair Poor Very poor

  • Very good
  • Good
  • Fair
  • Poor
  • Very poor

• External Condition of the building.

  Select Very good Good Fair Poor Very poor

  • Very good
  • Good
  • Fair
  • Poor
  • Very poor

• Is the property suitable to receive the insulation type specified?(Construction type, Exposer, Condition of Structure)

  Yes

  No

  N/A

• Have you done an internal inspection of the building?

  Yes

  No

  N/A

• If you have answered yes please select the best description of your findings.

  Select Low level damp near the skirting boards Black mould in the corners of the rooms Black mould on the ceiling and the walls Condensation on the windows and external walls No internal issues that I can see.

  • Low level damp near the skirting boards
  • Black mould in the corners of the rooms
  • Black mould on the ceiling and the walls
  • Condensation on the windows and external walls
  • No internal issues that I can see.

• Photos of Findings

  Media

• Safety monitors present.

  Select Smoke Alarm Fire Alarm CO Alarm

  • Smoke Alarm
  • Fire Alarm
  • CO Alarm

• Protected species or rodents present in building.

  Yes

  No

  N/A

• Please Specify

• Special Instructions. - (Parking, Directions, Second Contact, etc)

• On site parking.

• Client Instructions.

• Access Issues.

  Yes

  No

  N/A

• Brief Description

• Access Equipment Required.

  Select None Ladders Scaffold Board for Flat Roof Scaffolding Roof Ladder Lance System

  • None
  • Ladders
  • Scaffold Board for Flat Roof
  • Scaffolding
  • Roof Ladder
  • Lance System

• Please select if cavity Survey.

  If the answer is CWI
Elevation.

• Please List Elevation

  Select Front Elevation Rear Elevation Right Hand Side Elevation Left Hand Side Elevation Extension Front Elevation Extension Rear Elevation Extension Right Side Elevation Extension Left Side Elevation

  • Front Elevation
  • Rear Elevation
  • Right Hand Side Elevation
  • Left Hand Side Elevation
  • Extension Front Elevation
  • Extension Rear Elevation
  • Extension Right Side Elevation
  • Extension Left Side Elevation

• Photo Of Elevation

  Media

• Orientation of Elevation Faces

  Select North East South West North-East North-West South-East South-West

  • North
  • East
  • South
  • West
  • North-East
  • North-West
  • South-East
  • South-West

• Wall Area m2 (Excluding Windows & Doors)

• Elevation Drawing. (please mark the position of the Borescope hole with an S on drawing)

  Drawing

• Vents Present in Elevation

  Select Underfloor vents Kitchen Extractor vent Bathroom Extractor vent Cavity Room vents Combustion vent for burning appliance Windows Trickle Vents None

  • Underfloor vents
  • Kitchen Extractor vent
  • Bathroom Extractor vent
  • Cavity Room vents
  • Combustion vent for burning appliance
  • Windows Trickle Vents
  • None

• Alternate Walls Present

  Yes

  No

  N/A

• Alternate Wall Type

  Select Chimney Internal Garage Wall Solid Wall/Tile Hung Bay Window Other Internal Wall (Conservatory/Extension Wall)

  • Chimney
  • Internal Garage Wall
  • Solid Wall/Tile Hung
  • Bay Window
  • Other
  • Internal Wall (Conservatory/Extension Wall)

• Omitted m2

• Cavity Depth (mm) + Photo

• Borescope Photos

  Media

• DPC Photo

  Media

• Gutters & Downpipes Photo

  Media

• Comments/Remedial works Needed

Details

• Total Wall Area m2

• Total Omitted Area m2

• Total Area to be Insulated

• Average Cavity Depth over all Elevations

  Select 40mm 45mm 50mm 55mm 60mm 65mm 70mm 75mm 80mm 85mm 90mm 95mm 100mm 105mm 110mm 115mm 120mm 125mm 130mm 135mm 140mm 145mm 150mm 155mm 160mm 165mm 170mm 175mm 180mm 185mm 190mm 195mm 200mm

  • 40mm
  • 45mm
  • 50mm
  • 55mm
  • 60mm
  • 65mm
  • 70mm
  • 75mm
  • 80mm
  • 85mm
  • 90mm
  • 95mm
  • 100mm
  • 105mm
  • 110mm
  • 115mm
  • 120mm
  • 125mm
  • 130mm
  • 135mm
  • 140mm
  • 145mm
  • 150mm
  • 155mm
  • 160mm
  • 165mm
  • 170mm
  • 175mm
  • 180mm
  • 185mm
  • 190mm
  • 195mm
  • 200mm

• Door/Window Reveal Measurement (mm)

• Required Material

  EvoBead

  Thermabead Carbon

• Adjoining Property Insulated

  Yes

  No

  N/A

• Cavity Brush Barrier needed

  Yes

  No

  N/A

• How many?

• Any building defects including, Spalled, damaged Bricks & Cracks

  Yes

  No

  N/A

• Photo Of Findings

  Media

• Plants or Ivy attached to property

  Yes

  No

  N/A

• Photo Of Findings

  Media

• All Waste Pipes/Cables exiting through the property

  Yes

  No

  N/A

• Photo of Findings

  Media

• Working at Height issues

  Yes

  No

  N/A

• Photo Of Findings

  Media

• parking Issues

  Yes

  No

  N/A

• Photo Of Findings

  Media

• If Cavity please do a risk assessment.

  If the answer is CWI

• Use of a ladder/step ladder.

  Yes

  No

  N/A

• Noise.

  Yes

  No

  N/A

• Vibration.

  Yes

  No

  N/A

• Manual Handing.

  Yes

  No

  N/A

• Hand Tools/Power Tools

  Yes

  No

  N/A

• Compressed air.

  Yes

  No

  N/A

• Electricity/Generator

  Yes

  No

  N/A

• House keeping/site tidiness.

  Yes

  No

  N/A

• Working with with wet cement,concrete or mortar.

  Yes

  No

  N/A

• Overhead cables.

  Yes

  No

  N/A

• Reversing a vehicle.

  Yes

  No

  N/A

• Asbestos.

  Yes

  No

  N/A

• Use of a Mobile tower/MEWP

  Yes

  No

  N/A

• Lone Worker.

  Yes

  No

  N/A

• Please select if loft survey:

  Loft insulation only

• Photos of Loft (Full Panoramic of Loft + Loft Hatch Access)

  Media

• Area to be Insulated m2

• For ventilation are the eves visible form the loft space

  Yes

  No

  N/A

• Please evidence at least 4 areas

  Media

• Are there any forms of Ventilation present in roof space

  Yes

  No

  N/A

• Are there Soffit vents on the outside of the roof space

  Yes

  No

  N/A

• Can you identify any Damage to the underside of the Ceilings

  Yes

  No

  N/A

• Loft hatch size.

• Will Loft Hatch require Drought Proofing.

  Yes

  No

  N/A

• Is there a Loft Ladder pre installed

  Yes

  No

  N/A

• Existing depth.

  Select 0mm 12mm 25mm 50mm 70mm 80mm 100mm 125mm 150mm 200mm 250mm 270mm 300mm plus

  • 0mm
  • 12mm
  • 25mm
  • 50mm
  • 70mm
  • 80mm
  • 100mm
  • 125mm
  • 150mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm plus

• Photo of the existing insulation depth.

  Media

• Photo of Loft Declaration if applicable (ECO/GBIS Only)

  Media

• Depth to be added.

  Select 100mm 150mm 200mm 250mm 270mm 300mm

  • 100mm
  • 150mm
  • 200mm
  • 250mm
  • 270mm
  • 300mm

• Loft Height at Centre?

  Select 0.80 metres 0.90 metres 1.00 metres 1.20 metres 1.40 metres 1.50 metres 1.60 metres 1.80 metres and above.

  • 0.80 metres
  • 0.90 metres
  • 1.00 metres
  • 1.20 metres
  • 1.40 metres
  • 1.50 metres
  • 1.60 metres
  • 1.80 metres and above.

• In your opinion should the loft be Rolled or Blow?

  Rolled

  Blown

• Please draw the loft area, marking the hatch, pipes, tanks and combustion flue.

  Drawing

• Pipes and tanks present.

  Yes

  No

  N/A

• Details Of Pipes and Tanks to be Insulated

• Photo Of Pipes and Tanks

  Media

• Downlights present in ceiling?

  Yes

  No

  N/A

• Number of Down-lights & the Rooms located

• Rooms

  Select Living Room Hallway Kitchen Bathroom WC En-suite Landing Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Bedroom 5 Office/Study Dinning Room Utility Room

  • Living Room
  • Hallway
  • Kitchen
  • Bathroom
  • WC
  • En-suite
  • Landing
  • Bedroom 1
  • Bedroom 2
  • Bedroom 3
  • Bedroom 4
  • Bedroom 5
  • Office/Study
  • Dinning Room
  • Utility Room

• Downlight Photos

  Media

• Electrical wiring - Is there a High Powered Shower/Cooker Electrical cable in loft space

  Yes

  No

  N/A

• Are all cables free of visual defects

  Yes

  No

  N/A

• Does a combustion flue/Chimney pass through the loft space?

  Yes

  No

  N/A

• Photo of Combustion Flue/Chimney

  Media

• Poly wedges required?

  Yes

  No

  N/A

• Area to be omitted?

  Yes

  No

  N/A

• Please detail which area and m2

• Walkway to services required.

  Yes

  No

  N/A

• Walkway details length, position.

• Loft clearance required.

  Yes

  No

  N/A

• Will Customer Clear loft before install,

  Customer to Clear

  Landlord to Clear

  Customer unable to Clear

• Photo of Loft area to be cleared

  Media

• Customer Requires loft boarding Quote

  Yes

  No

  N/A

• Size of loft boarding required m2

• Please Inform Customer that Loft Boarding with be quoted by Contractor when survey is submitted

• Please select if Loft.

  Loft insulation only

• Use of a Step ladder/ladder

  Yes

  No

  N/A

• Access and Egress

  Yes

  No

  N/A

• Electric Lighting

  Yes

  No

  N/A

• Manual Handing

  Yes

  No

  N/A

• Hand Tools/Power Tools

  Yes

  No

  N/A

• Vibration

  Yes

  No

  N/A

• Noise

  Yes

  No

  N/A

• Dust

  Yes

  No

  N/A

• House Keeping

  Yes

  No

  N/A

• Lone Working

  Yes

  No

  N/A

• Please specify if Under Floor Insulation.

  Under Floor Insulation Only

• Are all surfaces of the sub floor construction which is to receive the installation suitable to receive insulation. and has the construction been detailed?

  Yes

  No

  N/A

• Is there adequate sub floor ventilation

  Yes

  No

  N/A

• Number of 9x3 floor vents

• Number of 9x6 floor vents

• Number of 9x9 floor vents

• Are all floor vents clear with airflow unobstructed

  Yes

  No

  N/A

• Total Floor Area to be installed (m2)

Suspended Floor

• is there an access point to the sub floor

  Yes

  No

  N/A

• are there any signs of water accumulation, visible leakage fromany underfloorpipes in the underfloor area

  Yes

  No

  N/A

• Entrance hatch location

• Entrance Hatch Size

• Floor Joist Spacings (mm)

• Floor Joist Depth (mm)

• Sub Floor depth (mm)

• Is there adequate space in floor void?

  Yes

  No

  N/A

• Pipe Work Present

  Yes

  No

  N/A

• Have all features/Services and risks been considered (cables, services, pipes etc)

  Yes

  No

  N/A

• Has the ventilation provision been assessed for combustion, if installed in a room with burning appliance

  Yes

  No

  N/A

• Depth of insulation to be installed (mm)

• Cavity Wall - PAS2030-Annex B_B1, I2

• Q1. Have you determined the installation of cavity wall insulation will not result in non-compliance with the Building Regulations, e.g. in relation to workmanship; materials; structural stability;<br>fire safety; resistance to moisture?<br>

  Yes

  No

• Q2. Have you determined the installation of cavity wall insulation will not result in unsafe operation of a combustion appliances?

  Yes

  No

• Q3. Have you determined the installation of cavity wall insulation will not compromise the functionality of existing ventilation ducts/systems?

  Yes

  No

• Q4. Have you determined the installation of cavity wall insulation will not compromise the functionality and/or safety of existing services (gas, electric, water, telephone, etc.)?

  Yes

  No

• Q5. Has the proposed installation been identified to be non-compliant with any requirements stated by the supplier

  Yes

  No

• Q6. Have you identified if the type and condition of the dwelling structure is suitable for the works to commence?

  Yes

  No

• Q7. Have you identified the extent of the cavity to be filled?

  Yes

  No

• Q8. Will the site layout or conditions impair the execution of the works?

  Yes

  No

• Q9. Have you identified if relevant checks have been undertaken to determine if materials containing asbestos are present?

  Yes

  No

• Q10. Has a recognised pre-notification process been undertaken under an industry quality assurance scheme for cavity wall<br>Insulation?<br>

  Yes

  No

• Q11. If the answer to Q10 is No has the pre-installation building inspection been independently checked by an appropriately<br>qualified person (see PAS2030 Annex B, B1-l3) prior to commencement of installation?<br>

  Yes

  No

• Loft Insulation - PAS20230-Annex B_B9,I2

• Q1. Have you determined any pre-existing damage to the areas that are accessed by the installation operatives?

  Yes

  No

• Q2. Have you determined the extent of the area and elements to be insulated?

  Yes

  No

• Q3. Have you determined if relevant checks have been undertaken to determine if materials containing asbestos are present?

  Yes

  No

• Q4. Will the roof space have appropriate ventilation?

  Yes

  No

• Q5. Is the roof space free from rodents/pests and protected species, e.g. bats?

  Yes

  No

• Q6. Are the roof space timbers free from rot and/or infestation?

  Yes

  No

• Q7. Have you determined the condition of the ceiling?

  Yes

  No

• Q8. If there are metal structural roof members are they free from visible signs of corrosion?

  Yes

  No

• Q9. Have you determined any electrical wiring is free from visible defects, e.g. damaged cables, trailing cables, exposed conductors?

  Yes

  No

• Q10. Are there any visible signs of leakage from water system components, e.g. pipework, cisterns, tanks?

  Yes

  No

• Q11. Are there any visible signs of water penetration?

  Yes

  No

• Q12. Have you investigated and determined that the Loft Insulation installation work will not result in the proposed installation being non-compliant with any requirements stated by the designer/specifier?

  Yes

  No

• Q13. Have you investigated and determined that the Loft Insulation installation work will not compromise the functionality of existing air supply/extract ventilation ducts/systems?

  Yes

  No

• Q14. Have you investigated and determined that the Loft Insulation installation work will not result in unsafe operation of any combustion appliances?

  Yes

  No

• Q15. Have you investigated and determined if the site layout or conditions would impair appropriate access to the property and to the roof space?

  Yes

  No

• Q16. Have you investigated and determined if the roof space will be free from stored items, boarding etc?

  Yes

  No

• Q17. Have you investigated and determined if the installation to be undertaken would not result in non-compliance with the Building Regulations, e.g. in relation to workmanship;<br>materials; structural stability; fire safety; resistance to moisture

  Yes

  No

• Q18. Has a recognised pre-notification process been undertaken under an industry quality assurance scheme for Loft Insulation?

  Yes

  No

• Q19. If the answer to Q18 is No has the pre-installation building inspection been independently checked by an appropriately<br>qualified person (see PAS2030 Annex B, B9-l3) prior to commencement of installation?

  Yes

  No

I can confirm that I have explained the install procedure, also highlight any areas of concern that have raisin during my survey which will need to be addressed before install. The survey will be passed to our contracting partners who will contact you in due course to arrange for a suitable date for the install of the works, Any technicians attending my property will conduct the install in accordance to industry guidelines and all relevant PPE at the time of install will be worn.

• Customer Signature

  Sign

I have assessed the condition on site ensuring there is adequate ventilation and no evidence of damp and no remedial works required unless listed in this survey and there are no additional significant hazards observed that are not addressed in the generic risk assessment for the work to be undertaken.

• Surveyors Signature

  Sign

• Date:

  Date