Information

  • Report Title

  • Location.
  • Client Name.

  • Tenure.

  • Property Type.

Property details

  • Report conducted by.

  • Confirmation that relevant checks have been undertaken to determine if the presence of any asbestos containing material is present?

  • Are there any items belonging to the owner of the property that may obstruct the work to be carried out

  • If the answer is yes please take photographic evidence of the condition of the item/items

  • Has an internal inspection of the property been carried out?

  • If yes, are all visible openings covered to stop ingress of material/dust

  • If yes please provide photographs

  • Does the property have working safety alarms fitted?

  • What is the main heating source of the building

  • What type of flue is present?

  • What type of ventilation is present?

  • External Inspection
  • Please take photos of all elevations

  • What is the external finish of the property

  • Is the external finish in a good condition

  • Are all guttering / downspouts in good repair with no evidence of leaks / spills? In addition, if guttering is a Finlock system has this been lined?

  • If no please explain

  • Is the DPC in good working order

  • Please provide photographic evidence where applicable

Extraction Report

  • What Material has been extracted

  • Are all elevations clear of material and rubble

  • What elevations need rubble removal

  • If no will a rubble removal be required

  • If rubble removal is required what is the linear meterage

  • Are all vents clear of ingress/material

  • Are the areas around the door and window openings clear of material

  • Is the flue clear of ingress/material

  • Please take photographic evidence where applicable

  • Are all extraction holes filled

  • Please provide example photos of filled holes

  • Is the cavity wall being refilled with Thermabead cavity wall insulation system

  • If yes please complete the pre and post cavity wall insulation survey

Borescope Photos

  • Front Elevation (min 4)

  • Rear Elevation (min 4)

  • Right Hand Elevation (min 4)

  • Left Hand Elevation (min 4)

  • Extensions (min 4)

  • Flue (Where applicable)

  • Wall Ties - Minimum of 2 per elevation

Surveyors Report

  • Please write a brief statement of the work that has been carried out

  • Surveyors Name

  • Date

Dynamic Risk Assessment & Client Declaration

Dynamic Risk Assessment.

  • Reversing vehicle.

  • Asbestos.

  • Overhead electricity cables.

  • Use of a step ladders or ladder.

  • Use of a mobile tower.

  • Manual Handling.

  • Working on a roof.

  • Hand tools.

  • Vibration.

  • Noise.

  • Electricity/Generator

  • Compressed air.

  • House keeping.

  • Installation of cavity wall.

  • Working with wet cement, concrete and mortar.

  • Use of mobile elevation working platform (mewp).

  • Lone worker.

  • Assessors signature

  • Date:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.