Information

  • Conducted on

  • Prepared by

  • Property Tenure

  • Landlord

  • Weather Conditions

  • Orientation of Front Elevation

Tenant/Homeowner Details

  • Name

  • Address
  • Phone Number

  • Email Address

  • Preferred Time of Contact

  • CIGA Guarantee Required

Property details

Property Details

  • Property Type

  • Detachment

  • Number of Occupants

  • Detachment

  • Flat position

  • Building finish

  • Type of mortar joint

  • Is mortar joint suitable for Cavity Wall Insulation

  • Is mortar joint suitable for Cavity Wall Insulation

  • Is mortar joint suitable for Cavity Wall Insulation

  • Is mortar joint suitable for Cavity Wall Insulation

  • Number of Bedrooms

  • Main Heating Type

  • Structural condition

  • Adequate ventilation to work area

  • Any evidence of damp identified

  • Fabric part of building damp identified

  • Type of damp identified

  • Area identified and cause

  • Cause

  • Cause

  • Cause

  • Cause

  • Cause

  • Area identified and cause

  • Type of damp identified

  • Area identified and cause

  • Area identified and cause

  • Area identified and cause

  • Is there evidence of mould present

  • Is mould found in multiple locations

  • Rooms mould has been identified

  • Is the mould well established

  • Is the mould well established

  • Is the mould well established

  • Is the mould well established

  • Is the mould well established

  • Is the area of mould more than 1m2 in each location identified

  • Are there any occupants under the age of 14 or over the age of 65 residing in the property

  • Do any occupants suffer with existing skin or respiratory problems

  • Do any occupants suffer with a compromised immune system

  • Photo of each elevation

  • Insulation Works Required

  • Photo Of Loft

  • Total Loft Area to be insulated

  • Existing Depth

  • Depth to installed

  • Relay Required

  • Tanks & Pipes need insulating

  • Any high amp cables present

  • Loft hatch needing DP/Insulating

  • Loft Vents Required

  • Down lights present

  • How many

  • F rated covers required

  • Walkway required

  • Are all elevations of the property deemed suitable for cavity wall insulation and meet CIGA/IAA methodology requirements?

  • Cavity Wall Insulation Total Area

  • Loft Hatch Photo

  • Floor Type

  • Required Material

  • KIWA Certification number

  • Existing Ventilation present

  • Type of room ventilation present

  • Average Cavity depth

  • Borescope Image

  • Cavity depth image

  • Number of cavity brushes required

  • Combustion Vent required

  • Image of appliance

  • Remedial works required

  • List of works required

  • To be completed by

  • DPC above floor level

  • Any access issues

  • Images of access issues

  • Total Area to be Extracted

  • Reason for extraction

  • Material being extracted

  • Recommended cavity drying time

  • What type of ventilation is required

  • Rooms requiring Mechanical extraction ventilation

  • Rooms requiring trickle ventilation

  • Rooms requiring demand control extraction vents

  • Reason for ventilation requirements

  • Total Area to be insulated

  • Is there sufficient ventilation to the underfloor area?

  • How many additional vents are to be installed?

  • Will Carpets/ Laminate flooring need to be uplifted?

  • Depth between floorboard and base?

  • Joist depth?

  • Is there any visible evidence of rotten timber joists present?

  • Caveat for External Wall Insulation

Access

  • On site parking

  • Reason for poor parking

  • Access Equipment Required

RAG Analysis, Summary and Costings

Summary of issues identified and causes

  • RAG Analysis of defects

  • Timeframe for remediation of defects

  • Timeframe for remediation of defects

  • Timeframe for remediation of defects

  • Issues Identified

Inspection Summary and Recommendations

  • Summary of measures and remediation works

  • Cost of Extraction Works

  • Cost of Loft Insulation works

  • Cost of loft relay works

  • Cost of DMEV installation works

  • Cost of remedial works

  • Cost of installation of French Drain

  • Cost of EWI works

  • Cost of servicing PIV works

  • Cost of Wall tie works

  • Cost of Rubble extraction works

  • Cost of loft extraction works

  • Cost of installation of CWI works

  • Cost of installation of IWI works

  • Cost of installation of FRI works

  • Cost of installing Demand control extraction ventilation works

  • Cost of installing Trickle ventilation works

  • Cost of installing PIR insulation board works

  • Cost of installing RIR works

  • Cost of installing Insulated Plasterboard works

  • Total Cost of Works to be supplied

  • Reference Number

Disclaimer

Dynamic Risk Assessment

  • Disclaimer

  • I have assessed the conditions on site ensuring there is adequate ventilation and no evidence of damp or excessive condensation issues unless otherwise stated previously within the survey report. There are no additional significant hazards observed that are not addressed in the generic risk assessment for the work to be undertaken.

  • Assessors signature

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