Information
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Technicians Names
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Crew?
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Address
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Date
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Prepared by
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Material System Card (Photo Required)
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Job number
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Crew Number
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Photo of the property
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Proof of batch number
HEALTH & SAFETY
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On site arrival Health & Safety observation
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All PPE being worn correctly?
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Has dynamic risk assessment been completed?
Pre & Post installation checks
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Has Pre & post checks been carried out
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Has flue safety checks been carried out
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Customer contact
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Survey form satisfactory
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Have flue checks been completed
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Has loft area been checked
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Moisture transfer Room
- Living Room
- Kitchen
- Bedroom
- Hallway
- Lounge
- Bathroom
- Other
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Where is ventilation coming from
- Under floor
- Trickle
- Expelair
- Room
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Sign of water ingress
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Any obvious cause to moisture transfer
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Are external walls in good condition
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Has cavity been breached previously ( if yes photos)
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Is roof in good condition
HEALTH & SAFETY EQUIPMENT CHECK
Ladders
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Triple Ladder Observation & ID Number
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Double Ladder observation & ID Number
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Step Ladder Observation & ID Number
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Ladder Strap observation
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Ladder Eye Bolt Observation
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Ladder Yoke Observation
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Ladder mats general observation & ID Number
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Stand off general observation & ID Number
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SDS drill/s observation & ID Number
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Core Drill observation & ID Number
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Lead light/torch observation
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Extension lead observation
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110 drill lead observation
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Transformer observation
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Hand tools observation
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All Electrical Equipment PAT Tested
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Date PAT Tested
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Renewal Date for PAT Testing
Compressor
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Make/model
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Hours worked (under key fob)
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Pressure setting
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Oil levels
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Safe working condition
Generator
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Make/Model
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Oil levels
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Safe working condition
Extraction Equipment
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Extraction fan in a safe working condition
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Extraction bin/pipe observation
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Contractor hose condition
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Directional nozzle/whip fittings condition
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Boroscope observation/working condition
Harness Restraint/s
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No.1 Harness observation & ID Number
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Cow's tail Observation & ID Number
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Drill Bandolier observation & ID Number
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No.2 Harness Observation & ID Number
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Cow's tail Observation & ID Number
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Drill Bandolier observation & ID Number
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No.3 Harness Observation & ID Number
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Cow's tail Observation & ID Number
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Drill Bandolier observation & ID Number
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Picture of all crew members wearing full PPE
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Picture of all Crew members using of restraint system
Extraction Process
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Material Extracted
- White wool
- Yellow wool
- White Bead
- Carbon Bead
- Diamond Bead
- Foam
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Photo of clear cavity?
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Identify Drill pattern
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Blowing technique
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Has extraction lanced been used
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Boroscope inspection
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Has whip been used
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Has directional nozzle been used
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Have extraction holes been plugged
Cavity Wall Insulation
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Cavity barrier been fitted
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Ventilation sleeved/clear
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Has Combustion vent been fitted
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Drill pattern correct
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Blowing sequence correct
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Making good
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Site organisation/cleanliness
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Has flue cert been fitted in the loft
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Does crew leader understand the failed smoke test procedure?
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Has Lance been used
Installation System
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Air pressure reading
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Pressure Vessel reading ?
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Condition of control board
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Thermabead labels present
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Condition of guns & 1m clear pipe
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Are there 'TWO' full sets of jets present?
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Spray jets clean and in good order?
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Condition of test kit
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Condition of hoses
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45 m flow rates glue/grams?
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30 m flow rates glue/grams?
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Lance equipment
Loft Installation
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Is all PPE being used correctly ?
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Are dust sheets being used
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Has recessed lights/power cables been identified before install & left clear of installation
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Are works at height be carried out safely
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Have all eaves and wedges been fitted
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Has the material been installed adequately
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Have all pipes and tanks been insulated correctly
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Has loft hatch and DP been fitted
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Has warning labels and loft certain been stapled in loft area
Vehicle inspection
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Vehicle Registration
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Mileage
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Any dash lights illuminated indicating maintenance required
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Cab cleanliness and organisation
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Compartments & storage areas organisation
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EH&S content observation
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First aid kit content observation
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Fire extinguisher observation
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Are all lights in a working order
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Are light lenses and mirrors in a good working condition
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Fluid levels checked and ok
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Are tyre treads road legal
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Tyre pressure ok (visual)
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Is the exterior of the vehicle clean
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Is there damage
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Photo of 4 sides of vehicle/ cab and working area
Variations notice issued notes and photos
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Final comments
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Photo's
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Crew leader Name & Signature
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Crew Assistant No2 Name & Signature
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Crew Assistant No3 Name & Signature
Inspectors name/signature of acknowledgement of responsibility to input accurate and true information, to clarify full compliance in line with the BBA/PAS2030 specification and requirements.
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Inspectors Name and Signature
