Title Page
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Site conducted
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Conducted on
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Job Type
- ROOF
- EWI
- RWG
- FASCIA
- 2ND ROOF
- LOFT INSUALTION
- CAVITY INSULATION
- RENDER
- PORCH
- WINDOW
- OTHER
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Prepared by
TENANT/HOMEOWNER
CLIENT/LANDLORD DETAILS
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Name
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Contact Number
PROPERTY DETAILS
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Property Type
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Sub Property Type
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Front Elevation
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Rear Elevation
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Orientation
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Front Elevation
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Rear Elevation
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Left Elevation
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Front Elevation
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Rear Elevation
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Right Elevation
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Orientation
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Front Elevation
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Rear Elevation
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Left Elevation
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Front Elevation
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Rear Elevation
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Right Elevation
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Front Elevation
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Rear Elevation
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Main Heating Type
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Please State Heating Type
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Appliance Type
- Gas Boiler
- Electric Storage Heaters
- Oil Boiler
- LPG Boiler
- Solid Fuel Boiler
- Electric Boiler
- Gas room Heaters
- Solid Fuel Room Heaters
- Electric Room Heaters
- Gas Fire with Back Boiler
- Gas Back Boiler to Radiators
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Position of Flue
- External
- Internal
- Front Elevation
- Rear Elevation
- Side Elevation
- Other
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Please state Location
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Photo of Gas meter
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Position of Flue
- External
- Internal
- Front Elevation
- Rear Elevation
- Side Elevation
- Other
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Position of Flue
- External
- Internal
- Front Elevation
- Rear Elevation
- Side Elevation
- Other
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Building Finish
- Exposed Brick
- Pebble Dash
- Other
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Render Finish
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Render Finish
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Mortar Colour
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External Wall Condition
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Photos
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Building Defects
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List Building Defects
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Photos of Defects
ACCESS
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On site Parking
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Client Instructions
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Neighbour Access Required
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Is Neighbour Aware
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Access Issues
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Please list Access Issues
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Photos Of Access Issues
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Access Equipment Required
- Ladders
- Scaffolding
- Conservatory Ladder
- Extraction Lance
- Installation Lance
- Other
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Please State Additional Equipment
INSPECTION SURVEY
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Survey Type
- Cavity
- Loft
- Ventilation
- External Wall Insulation
- Extraction
- Other
CAVITY WALL
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Scheme
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State type of scheme
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Total sqm to be Insulated
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Required Material
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If other please state
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Average Cavity Width
- 40mm
- 45mm
- 50mm
- 55mm
- 60mm
- 65mm
- 70mm
- 75mm
- 80mm
- 85mm
- 90mm
- 95mm
- 100mm
- 100mm+
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Please state correct average Cavity width
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Please select elevations to be installed
- Front
- Rear
- Left
- Right
- Extension
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Front Boroscope Photo
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Front DPC Photo
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Cavity Depth Photo
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Rear Boroscope Photo
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Rear DPC Photo
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Left Boroscope Photo
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Left DPC Photo
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Right Boroscope Photo
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Right DPC Photo
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Extension Boroscope Photo
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Extension DPC Photo
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Floor Type
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State floor Type
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Combustion vent Required?
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Photo of Appliance requiring Combustion vent
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Cavity Brush Required?
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Number of Cavity Brushes Required
- 1
- 2
- 3
- 4
- 5
- 5+
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Adjoining properties insulated?
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Reason Brushes not required
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Location of Chimneys
- Internal
- External
- Front Elevation
- Rear Elevation
- Side Elevation
- None
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Location of Flue
- Internal
- External
- Front Elevation
- Rear Elevation
- Side Elevation
- None
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Additional Notes
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Additional Photos
OTHER WORKS
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Please State Type of Works
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Details of required works
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Additional Information
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Photos
LOFT INSULATION
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Scheme
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State type of scheme
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Total Area to be Insulated
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Photo of Loft Hatch
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Photo of Loft space
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Existing Insulation
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Ofgem Loft Doc Required
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Photo of Loft Doc Close up
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Photo of Loft Doc in Situ
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Photo of existing depth
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Photo of Loft
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Down-lights present?
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Select Rooms Down-Lights Present
- Living Room
- Dining Room
- Kitchen
- Bathroom
- Bedrooms
- Other
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Additional room
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Total number of Down-Lights
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Any water tanks need insulating?
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Large Tank
- None
- 1
- 2
- 3
- 4
- 5
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Medium Tank
- None
- 1
- 2
- 3
- 4
- 5
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Small Tank
- None
- 1
- 2
- 3
- 4
- 5
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Photo of tanks
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Any Pipework require Lagging?
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Please state meters of pipework
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High Amp electrical cables present? (e:g; Power Shower, Cooker)
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Photo of appliance
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Photo of Power Switch
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Loft Hatch needing D/P
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Relay Required?
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Relay Sqm
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Areas to be omitted
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Total area to be omitted
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Loft Vents required
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Walkway required
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Mtrs Required
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Loft Clearance
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Additional Notes
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Additional Photos
DAMP INSPECTION
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Select Damp Issue
- Condensation
- Penetrating Damp
- Rising Damp
- Water Penetration
- Leaking Plumbing
- Other
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State Damp Issue
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Rooms Affected
- Living Room
- Dining Room
- Kitchen
- Bathroom
- Bedrooms
- Other
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Photos of Internal Issues
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Select rooms with issues
- Living Room
- Dining Room
- Kitchen
- Bathroom
- Bedrooms
- Other
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Photos of Internal Issues
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Has the property adequate ventilation
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Is there an obvious cause?
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Details
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Evidence
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Is the property in a good state of repair?
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Listed all Defects
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Description of Issue
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Conclusion
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Actions
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Additional Information
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Additional Photos
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Have Both Parties agreed to the measure?
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Is the Party Wall suitable to receive insulation?
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Area to be installed m2?
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Photo of Front elevation
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Photo of DPC Front
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Photo of Rear elevation
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Photo of DPC Rear
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Is there anything obstructing direct access to the Party Wall area?
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Any access issues that may require internal drill and fill of Party Wall?
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Photos of obstructions
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Has previously installed CWI migrated in to the Party Wall Void?
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Approximately how far has the Insulation migrated down the party wall void?
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Approximately how high up the void has the insulation risen?
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Photos of material migration in to party wall void
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Are there any openings in the internal gable walls?
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Photos of openings
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Photos of both internal gable walls!
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Step 1: Internally measure from internal party wall to window/door reveal on both properties (A + B)
Step 2: Externally measure from window/door wall edge to window/door wall edge on both properties measurement (C) minus A + B = measurement (D)
Step 3: Deduct Plaster (12mm) or Plaster & Batten (37mm) and finally Brick/Block (100mm) from measurement (D) = Cavity width (E)
Step 4: Chalk mark the cavity width on wall this will identify the centre of the cavity ready for cavity inspection. -
Photo of Measurement
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Photo of Party Wall Condition
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What is the finish on the internal walls?
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Photo of Internal walls
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If finish is Dot & Dab, is there a Parge coat present to a minimum of 8mm?
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Photo of Parge coat ( Identifiable within loft)
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State wall finish
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Are there any internal chimneys/flues present within the PW?
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Photo of Flue/Chimney on internal Party Wall
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If so distance from front & rear injection point?
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Spillage test required?
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Additional Comments
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Additional Photos
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Basic Checks
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Pre Appointment Made With Occupant
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Surveyor As Identification and Appropriate PPE
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Surveyor up to Date COVID-19 Guidelines Instructions
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Ask Housing Association, Local Authority, Principle Contractor Representative to Action
Property Information
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Property Dimensions
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Access Around Property
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Do Any Of The Surrounding Landscape Features Impact On The Installation
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Are There Any Delivery Restrictions?
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Are There Any Scaffolding Access Issues?
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Is There Space For Skips (If Required)
Basic EWI Information
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System Used
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New Top Coat Finish Specification
- Silicon
- Dash
- Brick Slip
- Brick Slip Detailing
- Winter Grade Gramamin
- Other
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Current External Finish Condition
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Property Architype
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Non-Traditional Description
- BISF
- Arcal
- Wimpey No Fines
- Cornish
- Airey
- TBC
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Additonal Notes (If Required)
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Additional Photos (If Required)
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Weather Conditions (At point of survey)
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Temperature
Construction Details Key
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Standard details refer to Standard Drawings
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Non standard details;- Detail will be designed & issued
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Installation notes:- needs to be discussed with site manager
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Installation team prior to work commencing
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Standard detail for Project Ref
Property Checks
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Plinths - Standard Details
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Cills - Standard Details
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Reveals - Standard Details
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Heads/ Lintels - Standard Details
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Facia/ Soffit - Standard Details
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Verge/ Eaves - Standard Details
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Window Surrounds - Standard Details
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Party Wall - Standard Details
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Party Wall Agreement in Place
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Outbuildings E.G. Conservatories, Greenhouses - Are There Any Outbuildings?
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Do the Outbuildings Affect The Install?
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Canopy - is there a Canopy?
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Canopy Type
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Is This Canopy Being Removed or Replaced
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Rainwater Goods - Standard Details
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Existing Rainwater Goods Type
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Are Rainwater Goods Being Replaced
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What Specification Is The New Rainwater Goods
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Soil And Waste - Standard Details
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Existing Soil And Waste Type
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Are the Soil Vent Pipe Being Replaced?
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What Specification Is The New SVP?
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Vents - Standard Details
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Locations of All Vents/ Extractor Fans
- Kitchen
- Bathroom
- En-Suite
- W/C
- Utility
- Other
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Window Trickle Vents Present
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Overflows - Standard Details
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Any Alterations Required?
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Boiler Flues - Standard Details
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Do Boiler Flues Need Alterations?
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Boiler Condensation Expansion Pipes - Standard Details
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Do Expansion Pipes Require Extension?
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Communication Installations E.G. Satellites/ TV Aerials
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Do any Communications Installations need taking off & refitting
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Greenery - Does It Require Trimming Back?
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Gates, Fences and Walls - Do The Gates, Fences or Walls Require Alterations
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External Electrical Equipment - Does It Need Alterations?
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Residential Fixtures and Fittings - Does It Need Alterations?
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Gas and Electrical Utility Fixtures - Does It Need Alterations?
Measurements
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Property Dimensions
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Solid Wall m² (Solid Measure Including Windows)
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Linear Meterage of Window & Door Heads, Reveals and Cills
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Total m² of External Window and Door Apertures
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Total m² Silicon Finish To Windows & Doors (Window Reveal)
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Base Rail Length (Metres)
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Base Track Nosing
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Mid Cast Bead
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Number of External Quoins On Property
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Cills Length (Metres)
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Party Wall Length (Metres)
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Expansion Joint (Metres) (If Semi and Both Properties Being Installed)
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System Stop End (Metres) (If Semi and Both Properties Being Installed)
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Verge Trim (If Applicable)
Enabling Works
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Downpipe Enable Length (Metres)
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Does a Water Tap Need To Be Removed?
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Number of Taps
- 1
- 2
- 3
- 4
- 5
- 5+
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Any Extractor Alterations?
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Any Gas Pipe Alterations?
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Gas Pipe Alternations Length (Metres)
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No. Of Satellite Dishes
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No. Of TV Aerials
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No. Of External Lights
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SVP Enabling
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SVP Alterations of Drains Required?
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No. Of OFF Set Bends
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No. Of Over Flows
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Length? (Metres)
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No. Of Over Flow Bends
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Meter Box Alterations Required?
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PAS 2035 Design Achievable?
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Replacement Required?
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Are There Clothe Line Alterations Required?
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Fence Post Alterations Required?
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Can We Reuse Fence?
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No. Of New Fence Post Needed
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No. Of New Fence Panels Needed
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No. Of New Gates Needed
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Re - Instating
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Can We Refit Existing DP
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Length of New DP Needed
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No. of DP Brackets Needed
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No. of DP Swan Necks Needed
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No. of DP Toe Needed
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Do We Need To Fit Gas Extractor Vents
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Re - Instating Others
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Clip Wires Needed?
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How Many?
Additional Information and Evidence
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Brick Slip / Brick Render Soldier Courses
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Photographs Non-Detail of Required
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Additional Photographs
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Any Additional Notes
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Have all Rooms Been Inspected for Condensation and Damp?
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Room Types
- Kitchen
- Bathroom 1
- Bathroom 2
- En- Suite 1
- En-Suite 2
- W/C
- Utility
- Other
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Photos of all Wet Rooms in Property
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Does the Property Need any Additional Ventilation Work in Preparation for Insulation Measure
RISK ASSESSMENT
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Undertake Risk Assessment
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Type of Works
- Cavity Wall
- Loft
- EWI
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Cavity Wall Insulation Risk Assessment Questions
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Overhead Electricity Cables Present?
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Does the Property have a Garage?
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Does the Property have a Porch?
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Does the Property have an Outside Tap?
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Does the Property have Finlock Gutters?
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Does the Property suggest that Asbestos could be Present?
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Access from Road/ Around Property
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Is there any Evidence of Vermin?
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Is there any Evidence of Protected Wildlife? (e.g. Bats)
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Use of a Mobile Tower Required?
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Working on Roof Required?
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Vibration Likely?
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High Noise Levels Likely?
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Working with Wet Cement/ Concrete/ Mortar required?
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Use of Mobile Elevation Working Platform (MEWP) required?
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If Obstructions present, can an extended Lance be used to Remedy?
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Reversing of Vehicle Required?
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Electricity Required?
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Housekeeping Required
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Distance from Works vehicle to Property
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Will Public Walkway be at Risk?
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Is neighbour access required?
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Safety Signage required?
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Loft Insulation Risk Assessment Questions
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Does the Property suggest that Asbestos could be Present?
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Confirm you have asked the Client if there was any known Asbestos or Asbestos containing materials within the property
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Do you or the Client have any Reason to suspect Asbestos is present in the Property?
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Have all checks been Undertaken to determine if Asbestos containing materials are present within the property?
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Access from Road/ Around Property
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Is there any Evidence of Vermin?
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Is there any Evidence of Protected Wildlife? (e.g. Bats)
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Vulnerable Person Present?
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Use of Ladders Required?
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Manual Handling Required?
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Reversing of Vehicle Required?
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Electricity Required?
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Housekeeping Required
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Distance from Works vehicle to Property
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Will Public Walkway be at Risk?
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Is neighbour access required?
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Safety Signage required?
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Electricity Cables present in Loft
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Working in Confined Spaces required?
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Lone Working?
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Use of Scaffold required?
DYNAMIC RISK ASSESSMENT
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I has assessed the conditions on site ensuring there is adequate ventilation. Unless listed below, there are no additional significant hazards observed that are not addresses in the generic risk assessment for the works to be undertaken
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Assessors Name and Signature
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Customer's name and Signature
