Ridgewater Energy Ltd - Insulation Survey

• Client Name.

• Contact Phone

• Contact Email

• First Line of Address

• Location.
  Address

• Tenure.

  Select Owner occupier Local Authority Housing Association Privately Rented

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

• Scheme type.

  Select PRIVATE (ATP) ECO4 HHD Non Eco HUG COMF/COLA

  • PRIVATE (ATP)
  • ECO4
  • HHD Non Eco
  • HUG
  • COMF/COLA

• Survey conducted by.

  Steve Bright

  Pete Bywater,

  Johnny Fox

  Chris Denman

• 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
  • Suspended not wood
  • Other

• 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

• 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

• Have the alarms all been tested by surveyor.

• Protected species or rodents present in building.

  Yes

  No

  N/A

• Please Specify

• Special Instructions.

• 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 Conservatory Ladder Roof Ladder Injection Lance System

  • None
  • Ladders
  • Scaffold Board for Flat Roof
  • Scaffolding
  • Conservatory Ladder
  • Roof Ladder
  • Injection 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 Extrator vents Bathroom Extrator vents Room vents Combustion vent Windows Trickle Vents None

  • Underfloor vents
  • Kitchen Extrator vents
  • Bathroom Extrator vents
  • Room vents
  • Combustion vent
  • 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

  • Chimney
  • Internal Garage Wall
  • Solid Wall/Tile Hung
  • Bay Window
  • Other

• 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 Wall Area m2 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 Available

  Yes

  No

  N/A

• Door/Window Reveal Measurement (mm)

• Door/Window Reveal Photo

  Media

• 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

• Loft hatch size.

• Will Loft Hatch require Drought Proofing.

  Yes

  No

  N/A

• Is there a Loft Ladder pre installed

  Yes

  No

  N/A

• Area to be Insulated m2

• 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

  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

• Details of the number of Downlights & the Rooms located

• Downlight Photos

  Media

• Electrical wiring free from visual defects?

  Yes

  No

  N/A

• Does a combustion flue pass through the loft space?

  Yes

  No

  N/A

• Photo of Combustion Flue

  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, Or Ridgewater to help with Loft Clearance?

  Customer to Clear

  Ridgewater to Clear

• Please inform Customer this my incur an extra charge

• 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

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Access and Egress

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Electric Lighting

  Yes

  No

  N/A

• Manual Handing

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Hand Tools/Power Tools

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Vibration

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Noise

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Dust

  Select Yes No N/A

  • Yes
  • No
  • N/A

• House Keeping

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Lone Working

  Select Yes No N/A

  • 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)

• Will the installation Work result in Non-Compliant with Building Regulations E.g. workmanship, Materials etc?

  Yes

  No

  N/A

• Will the installation work result in unsafe operations of a combustion appliance E.g Flue?

  Yes

  No

  N/A

• Will the installation work result in the compromise to the functionality of existing ventilation?

  Yes

  No

  N/A

• Will the installation work result in the compromise to the functionality and or safety of existing services?

  Yes

  No

  N/A

• Type & Condition of the building structure suitable for works to commence?

  Yes

  No

  N/A

• Will the installation work result in installation that is Non-compliant material supplier requirements

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Property Drilled to establish clear cavity/width?

  Yes

  No

  N/A

• All areas to be insulated agreed with customer?

  Yes

  No

  N/A

• Any areas not to be insulated agreed with customer?

  Yes

  No

  N/A

• Any areas to be fill internally agreed with customer?

  Yes

  No

  N/A

• Scaffolding supplied by customer?

  Yes

  No

  N/A

• What is the Extent of the cavity to be filled (%)

• What is the Extent of the loft to be laid (%)

• Will the site layout or conditions impair the execution of the works

  Yes

  No

  N/A

• Is there any potential for moisture build up as a result of the install?

  Yes

  No

  N/A

• Will the function or safety of (gas, electricity, water, telecommunications etc.) be affected in any way as a result of the install?

  Yes

  No

  N/A

• Is there any risk in relation to the ongoing performance of installed services?

  Yes

  No

  N/A

• From the finding of the survey, is the install able to be carried out in line with the full design specification?

  Yes

  No

  N/A

• From The Findings of the Survey, is the method statement suitable and complete?

  Yes

  No

  N/A

• Is there any evidence that any form of protected species would be disturbed by the installation process?

  Yes

  No

  N/A

• Does the customer understand the nature and extent of the work?

  Yes

  No

  N/A

• Have they been made aware of any disruption that may be caused?

  Yes

  No

  N/A

• Does the customer have any particular requests or requirements?

  Yes

  No

  N/A

• Are the arrangements for site access and the storage if insulation materials adequate and appropriate?

  Yes

  No

  N/A

• Is there any other information which would help ensure the smooth running of the install?

  Yes

  No

  N/A

• Number of Smoke/CO Alarms

• Benefit Letter or Utility Bill available

  Yes

  No

  N/A

• Photo required

  Media

• Have LA Flex Forms been completed if Required

  Yes

  No

  N/A

• 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