SDC EXTERNALS - Potential Measures Survey

• Site conducted

  Select

• Conducted on

  Date

• Job Type

  Select ROOF EWI RWG FASCIA 2ND ROOF LOFT INSUALTION CAVITY INSULATION RENDER PORCH WINDOW OTHER

  • ROOF
  • EWI
  • RWG
  • FASCIA
  • 2ND ROOF
  • LOFT INSUALTION
  • CAVITY INSULATION
  • RENDER
  • PORCH
  • WINDOW
  • OTHER

• Prepared by

CLIENT/LANDLORD DETAILS

• Name

• Contact Number

• Property Type

  House

  Bungalow

  Flat

  Maisonette

• Sub Property Type

  Detached

  Semi Detached

  End Terrace

  Mid Terrace

• Front Elevation

  Media

• Rear Elevation

  Media

• Orientation

  Left

  Right

• Front Elevation

  Media

• Rear Elevation

  Media

• Left Elevation

  Media

• Front Elevation

  Media

• Rear Elevation

  Media

• Right Elevation

  Media

• Orientation

  Left

  Right

• Front Elevation

  Media

• Rear Elevation

  Media

• Left Elevation

  Media

• Front Elevation

  Media

• Rear Elevation

  Media

• Right Elevation

  Media

• Front Elevation

  Media

• Rear Elevation

  Media

• Main Heating Type

  Gas

  Electric

  Oil

  Solid Fuel

  Other

• Please State Heating Type

• Appliance Type

  Select 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

  • 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

• Position of Flue

  Select External Internal Front Elevation Rear Elevation Side Elevation Other

  • External
  • Internal
  • Front Elevation
  • Rear Elevation
  • Side Elevation
  • Other

• Please state Location

• Photo of Gas meter

  Media

• Position of Flue

  Select External Internal Front Elevation Rear Elevation Side Elevation Other

  • External
  • Internal
  • Front Elevation
  • Rear Elevation
  • Side Elevation
  • Other

• Position of Flue

  Select External Internal Front Elevation Rear Elevation Side Elevation Other

  • External
  • Internal
  • Front Elevation
  • Rear Elevation
  • Side Elevation
  • Other

• Building Finish

  Select Exposed Brick Pebble Dash Other

  • Exposed Brick
  • Pebble Dash
  • Other

• Render Finish

  Exposed Brick

  Pebble Dash

  Other

• Render Finish

• Mortar Colour

  Grey

  Buff

  Red

  Brown

  Other

• External Wall Condition

  Sound

  Un-Sound

  N/A

• Photos

  Yes

  No

• Building Defects

  Yes

  No

• List Building Defects

• Photos of Defects

  Media

ACCESS

• On site Parking

• Client Instructions

• Neighbour Access Required

  Yes

  No

• Is Neighbour Aware

  Yes

  No

• Access Issues

  Yes

  No

• Please list Access Issues

• Photos Of Access Issues

  Media

• Access Equipment Required

  Select Ladders Scaffolding Conservatory Ladder Extraction Lance Installation Lance Other

  • Ladders
  • Scaffolding
  • Conservatory Ladder
  • Extraction Lance
  • Installation Lance
  • Other

• Please State Additional Equipment

• Survey Type

  Select Render & Cavity External Wall Insulation

  • Render & Cavity
  • External Wall Insulation

LOFT INSULATION

• Total Area to be Insulated

• Photo of Loft Hatch

  Media

• Photo of Loft space

  Media

• Existing Insulation

  Yes

  No

  N/A

• Photo of Loft

  Media

• Depth to be Installed

• Any Pipework require Lagging?

  Yes

  No

  N/A

• Please state meters of pipework

• Loft Clearance

  Yes

  No

• Additional Notes

• Is the property in a good state of repair?

  Yes

  No

  N/A

• Listed all Defects

• Is the Party Wall suitable to receive insulation?

  Yes

  No

• Is there anything obstructing direct access to the Party Wall area?

  Yes

  No

• Any access issues that may require internal drill and fill of Party Wall?

  Yes

  No

• Photos of obstructions

  Media

• Are there any openings in the internal gable walls?

  Yes

  No

• Photos of openings

  Media

• Photos of both internal gable walls!

  Media

• Additional Comments

• Additional Photos

  Media

• Yes

  No

Basic Checks

• Pre Appointment Made With Occupant

  Yes

  No

  N/A

Property Information

• Access Around Property

  Good

  Fair

  Bad

• Are There Any Scaffolding Access Issues?

  Yes

  No

  N/A

• Is There Space For Skips (If Required)

  Yes

  No

  N/A

Basic EWI Information

• System Used

  Wetherby

  TBC

• New Top Coat Finish Specification

  Select Silicon Dash Brick Slip Brick Slip Detailing Winter Grade Gramamin Other

  • Silicon
  • Dash
  • Brick Slip
  • Brick Slip Detailing
  • Winter Grade Gramamin
  • Other

• Current External Finish Condition

  Good

  Fair

  Poor

  N/A

• Property Architype

  Traditional

  Non-Traditional

• Non-Traditional Description

• Additonal Notes (If Required)

• Additional Photos (If Required)

  Media

Enabling Works

• Does a Water Tap Need To Be Removed?

  Yes

  No

  N/A

• Number of Taps

  Select 1 2 3 4 5 5+

  • 1
  • 2
  • 3
  • 4
  • 5
  • 5+

• Any Extractor Alterations?

  Yes

  No

  N/A

• Any Gas Pipe Alterations?

  Yes

  No

  N/A

• No. Of Satellite Dishes

• No. Of TV Aerials

• No. Of External Lights

• Meter Box Alterations Required?

  Yes

  No

  N/A

• Replacement Required?

  Yes

  No

  N/A

• Fence Post Alterations Required?

  Yes

  No

  N/A

• Does the Property Need any Additional Ventilation Work in Preparation for Insulation Measure

  Yes

  No

  N/A

Additional Notes

• Additional Notes

• Undertake Risk Assessment

• Type of Works

  Select Cavity Wall Loft EWI

  • Cavity Wall
  • Loft
  • EWI

• Overhead Electricity Cables Present?

  Yes

  No

• Does the Property have a Garage?

  Yes

  No

• Does the Property have a Porch?

  Yes

  No

• Does the Property have an Outside Tap?

  Yes

  No

• Does the Property have Finlock Gutters?

  Yes

  No

• Does the Property suggest that Asbestos could be Present?

  Yes

  No

• Access from Road/ Around Property

  Good

  Fair

  Poor

  N/A

• Is there any Evidence of Vermin?

  Yes

  No

• Is there any Evidence of Protected Wildlife? (e.g. Bats)

  Yes

  No

• Use of a Mobile Tower Required?

  Yes

  No

• Working on Roof Required?

  Yes

  No

• Vibration Likely?

  Yes

  No

• High Noise Levels Likely?

  Yes

  No

• Working with Wet Cement/ Concrete/ Mortar required?

  Yes

  No

• Use of Mobile Elevation Working Platform (MEWP) required?

  Yes

  No

• If Obstructions present, can an extended Lance be used to Remedy?

  Yes

  No

• Electricity Required?

  Yes

  No

• Housekeeping Required

  Yes

  No

• Will Public Walkway be at Risk?

  Yes

  No

• Is neighbour access required?

  Yes

  No

• Safety Signage required?

  Yes

  No

• Have you checked the Asbestos Report?

  Yes

  No

• Access from Road/ Around Property

  Good

  Fair

  Poor

  N/A

• Is there any Evidence of Vermin?

  Yes

  No

• Is there any Evidence of Protected Wildlife? (e.g. Bats)

  Yes

  No

• Vulnerable Person Present?

  Yes

  No

• Use of Ladders Required?

  Yes

  No

• Manual Handling Required?

  Yes

  No

• Electricity Required?

  Yes

  No

• Housekeeping Required

  Yes

  No

• Will Public Walkway be at Risk?

  Yes

  No

• Is neighbour access required?

  Yes

  No

• Safety Signage required?

  Yes

  No

• Electricity Cables present in Loft

  Yes

  No

• Working in Confined Spaces required?

  Yes

  No

• Use of Scaffold required?

  Yes

  No

• Overhead Electricity Cables Present?

  Yes

  No

• Does the Property have a Garage?

  Yes

  No

• Does the Property have a Porch?

  Yes

  No

• Does the Property have an Outside Tap?

  Yes

  No

• Does the Property have Finlock Gutters?

  Yes

  No

• Does the Property suggest that Asbestos could be Present?

  Yes

  No

• Access from Road/ Around Property

  Good

  Fair

  Poor

  N/A

• Is there any Evidence of Vermin?

  Yes

  No

• Is there any Evidence of Protected Wildlife? (e.g. Bats)

  Yes

  No

• Use of a Mobile Tower Required?

  Yes

  No

• Working on Roof Required?

  Yes

  No

• Vibration Likely?

  Yes

  No

• High Noise Levels Likely?

  Yes

  No

• Working with Wet Cement/ Concrete/ Mortar required?

  Yes

  No

• Use of Mobile Elevation Working Platform (MEWP) required?

  Yes

  No

• If Obstructions present, can an extended Lance be used to Remedy?

  Yes

  No

• Electricity Required?

  Yes

  No

• Housekeeping Required

  Yes

  No

• Will Public Walkway be at Risk?

  Yes

  No

• Is neighbour access required?

  Yes

  No

• Safety Signage required?

  Yes

  No

• Assessors Name

• Date Signed

  Date