Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Customer details
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Customer name and post code
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Type of supply
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Surveyor
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date
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Location
Property info
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Type of Property (house Bungalow)
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Age of Property
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bedrooms?
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photos of property
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Is the property exposed
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Type of wall external
- cavity as built
- cob
- cob insulated
- filled cavity
- stone brick
- stone brick with insulation
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Type of wall internal
- 100mm block with cavity
- brick 102.5mm
- brick 215
- plasterboard with studding
- standard aerated block 100mm
- standard aerated block 125mm
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Roof Type
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Floor
- ground floor 100mm insulated
- ground floor 25mm insulated
- ground floor 50mm insulated
- ground floor 75mm insulated
- ground floor current build regulations
- ground floor no insulation
- intermediate floor with timber
- intermediate floor without timber
- party floor concrete with insulation
- party floor without insulation
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Windows Double Glazed?
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door
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ceiling infomation
- 100mm insulated
- 200mm insulated
- 300mm insulated
- 50mm insulated
- building regulations 2006
- flat roof no insulation
- intermediate floor timber with insulation
- intermediate floor without insulation
- party floor concrete without insulation
- party floor concrete with insulation
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wall height ground basement
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wall height ground floor
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wall height first floor
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wall height second floor
Energy & install locations
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What are they interested in? ASHP or Solar
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Current Energy Fuel
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Location of existing boiler
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Picture
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flue location (picture)
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existing cylinder?
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Existing Cylinder Photo
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Proposed Cylinder Location
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Proposed cylinder location
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Proposed ASHP Location
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Proposed ASHP Location
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Consumer Unit Location
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Consumer Unit
Rooms Radiator Locations
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living room
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radiator dimensions h x w and type
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lounge
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radiator dimensions h x w and type
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hallway 1
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radiator dimensions h x w and type
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hallway 2
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radiator dimensions h x w and type
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kitchen
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radiator dimensions h x w and type
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dining room
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radiator dimensions h x w and type
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conservatory
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radiator dimensions h x w and type
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wc
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radiator dimensions h x w and type
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utility
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radiator dimensions h x w and type
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garage
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radiator dimensions h x w and type
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bedroom 1
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radiator dimensions h x w and type
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bedroom2
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radiator dimensions h x w and type
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bedroom3
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radiator dimensions h x w and type
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bedroom 4
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radiator dimensions h x w and type
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bedroom 5
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radiator dimensions h x w and type
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en-suite 1
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radiator dimensions h x w and type
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en-suite 2
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radiator dimensions h x w and type
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bathroom
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radiator dimensions h x w and type
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floor plan
Hot Water
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output capacity of primary heat source at design conditions
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flow temp while providing hot water
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will an auxiliary heat source be required?
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number of bedrooms
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number of occupants
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litres per person per day
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hot water temperature required
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heat loss associated with water storage (5)
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incoming water temp (10)
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pipework efficiency of primary heat source
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legionella purge
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purge frequency
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purge hours per day (3)
DWH Cylinder Details
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make
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model
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dhw chosen cylinder capacity
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electric emersion heater size (usually 3)
Heat Pump
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Does the Property have a valid EPC
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Annual Space Heating Demand
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Annual Hot Water Demand
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reference number on EPC
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date of epc
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any other heat sources
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cost per unit of electricity (pence)
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cost per unit of existing fuel (pence per KW)
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Cost of Total Installation (£)
Sound Power Levels
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sound power level (DB)
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reflective surfaces
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distance from heat pump to assessment point? (M)
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barriers?
Additional Info
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any additional info needed
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additional pictures that may be needed
