Customer Details

Ref ID

Name*

Address*

Phone

Email*

What 3 Words Address

https://what3words.com

Current EPC Rating

Look up EPC

Lead

Photo of the Front of Home or Building

Drop files here or

Max. file size: 256 MB.

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Grants & Schemes

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Type of customer

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Grant Application For ECO Grants?*

Yes
No

Is the applicant on benefits?*

Yes
No

What benefits is the applicant on?

Council Tax Band of Property

A-D Council Tax Band
E-G Council Tax Band
Unknown

Type of Works

Type of Insulation work*

Party Wall

Not Included.
Party Wall Only
Party Wall and Cavities

About The Building

Age of building*

New Construction
Retro fit for existing building

Type of building*

Style*

Construction*

Condition of Brick and pointing or render*

Type of Floor

Timber suspended
Solid Concrete Base
Other

How many air bricks are required?

Heating System*

Number of Bedrooms?

Number of Flats?

Is an extractor fan required for the Kitchen*

Yes
No

Is an extractor fan required for bathrooms?*

Yes
No

About the Cavity

Are Cavity Walls Showing Damp*

Yes
No

Are The Cavities Empty*

Yes
No

Is Extraction Required*

Yes
No

What Type of Insulation?*

Depth of Cavity*

Is this a Partial Fill*

No
Yes

Is a lance required

No a Lance is not required
Yes a Lance is required

Areas Requiring Insulating

Main Home or Building*

Yes
No

Does Gable Wall Top Section need insulating?*

Yes
No

Does Extension need insulating?*

Yes
No

Insulate Conservatory?*

Yes
No

Insulate Home/Garage party wall?*

Yes
No

Insulate Garage External Wall*

Yes
No

Other:

Are Cavity Barriers Required?*

Yes
No

Where?*

Semi Detached Boarders
Mid Terrance Boarders
Extensions works

Behind Tiles/Gladding with internal fill?*

Yes
No

Is there a fire place?*

Yes
No

What type of fire place?*

Open Fire Place
Log Burner
Gas Fire

What KW size is the fire place?

Does it require a core vent ?*

Yes
No
Unsure

How many fire places that require core vents?

Is there an Aga?*

Yes
No

Are remedial works required

No
Yes

Required Remedial Works

Such as anything that should be done before or after install.

About the Spray Task

Job Type*

Attic Roof
Drill and Fill Eaves
Room in Attic
Commercial or Shed Roof
Static Caravan
Roof and Sides of Shed

Pass Moisture Test*

Yes
No

Been Fully Measured*

Yes
No

Depth of Rafters over 100mm*

Yes
No

Condition of Rafters*

Good
Fair
Poor
Critical

Is Felt Present?*

Yes
No

Condition of Felt*

Does it need membrane*

Yes
No

Loft Floor Is Boarded?*

Yes
No
Partly

Light Required?*

Yes
No

Ladder Required?*

Yes
No

Loft Insulation

Does loft currently have laid insulation

Yes
No

Will current insulation remain in place

Yes
No

Current Depth of Insulation

Current Depth of Joists

Is the existing ventilation within the loft space adequate and un-restricted?

Yes
No

Is there any evidence of high moisture readings, dampness, mould or water ingress?

Yes
No

Are Downlighters present?

Yes
No

Number of downlighter to cover?

Is attic boarded

Yes
No
Partly

Will pipe lagging be added?*

Yes
No

Meters of lagging required?

Will water tank require insulation?*

Yes
No

External Wall Insulation

Are all roof over hangs wide enough?

Yes
No

Describe which ones are not wide enough

Does Soil pipe need moving?

Yes
No

Does electric cable need removing?

Yes
No

Type of Insulation Board

EPS
XPS
Mineral Wool

Thickness

90mm
Less than 90
more thank 90

Type of Render

Normal Silicon
Coastal Silicon
Trees Silicon
High End

Colour?

Check list for cavity wall installs

Is Neighbour Access Required?*

Yes
No

Cavities have been inspected?*

Yes
No

Agreed Areas Requiring Insulation?*

Yes
No

Scaffolding Required?*

Yes
No

Has the client been told to cut back bushes climbing on walls?*

Yes
No

Has the client been told we will fit a core vent for fire places that require one?*

Yes
No

Has the client been told to fit relevant extractor fans if missing?*

Yes
No

Has the client been told to rectify any bad pointing if present?*

Yes
No

Has the client been told these will invalidate the guarantee if not completed?*

Yes
No

Is the DPC at least 150mm above ground?*

Yes
No

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ALL ELEVATIONS

Drop files here or

Max. file size: 256 MB.

Front, left, Right, Rear etc.

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Additional External Photos

Drop files here or

Max. file size: 256 MB.

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Photos Showing All Elevations Cavity, Depth & Scope

Drop files here or

Max. file size: 256 MB.

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DPC, Air Bricks, Fire Places, Log Burners, Boilers, External Flues, Extractor fans, Trickle Vents, Loft Gabel End

Drop files here or

Max. file size: 256 MB.

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Floor Plans and Building Diagrams

Drop files here or

Max. file size: 256 MB.

Please draw the building plan with any conservation's including where scope holes were drilled.

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Photos Showing Damp in Rooms if present.

Drop files here or

Max. file size: 256 MB.

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Other Photos

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Photos of required remedial works

Drop files here or

Max. file size: 256 MB.

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Loft Photos

Drop files here or

Max. file size: 256 MB.

Notes

Maximum distance from van to furthest section of job.

Under 45 meters
45 - 60 meters

Survey Notes

Such as anything not straight forward, like finding the place, where to park, which walls to insulate or any comments by the home owner worth knowing. Difficult access points, awkward over hangs etc.

Square Meter Measurements

Total Area for Extraction

Total Area for Cavity Wall Insulation

How many Rooms Require Extractor Fans?

Square Meters of Membrane

Total Area for Spray Foam Insulation

Depth of loft insulation to be Added (mm)

Total Area for Loft Insulation

Total Area for External Wall Insulation

Quotation

Total Cost of Cavity Extraction

Total Cost of Cavity Wall Insulation*

Cavity Wall Insualtion 25 Year Guarantee*

Total Cost of Extractor Fans*

Total Cost of Spray Foam Insulating*

Total Cost of Loft Insulation*

Total Cost of External Wall Insulation*

The Survey

Name of Surveyor

Date of Survey

Message to client

Property Photos

ALL ELEVATIONS

Cavity Photos

We need photos of:
• 2 scope holes per each elevation showing cavity
• Photo of the scope in each hole.
• Photos of cavity depth

Photos Showing All Elevations Cavity, Depth & Scope

General Photos

DPC, Air Bricks, Fire Places, Log Burners, Boilers, External Flues, Extractor fans, Trickle Vents, Loft Gabel End

Floor Plans and Building Diagrams

Please draw the building plan with any conservation's including where scope holes were drilled.

Photos Showing Damp in Rooms if present.

Photos of required remedial works

Loft Photos

Please upload all the below Loft photos:

Loft hatch, Existing depth, Down lights, tanks, vents, Photos of current loft insulation. Draft proofing. Tanks and pipe insulation.

All Loft Photos

ABLE TO SURVEY

Customer Details

Grants & Schemes

Type of Works

About The Building

About the Cavity

Areas Requiring Insulating

About the Spray Task

Loft Insulation

External Wall Insulation

Check list for cavity wall installs

Other Photos

Notes

Square Meter Measurements

Quotation

The Survey

Property Photos

Cavity Photos

General Photos

Loft Photos