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* indicates required fields 
  *DWELLING TYPE:
  MPRN NO:
  DATE OF ASSESSMENT:
  BUILDING REGULATIONS:
  YEAR OF CONSTRUCTION:
  PROPERTY ADDRESS:
  CLIENT NAME & ADDRESS:
  GROUND FLOOR:
  GROUND FLOOR CEILING:
  FIRST FLOOR:
  FIRST FLOOR CEILING:
  LIVING AREA:
  NO. OF STORIES:
  NO. OF CHIMNEYS:
  NO. OF OPEN FLUES:
  NO. OF PASSIVE VENTS/EXTRACTOR FANS:
  NO. OF FLUELESS GAS FIRES:
  DRAUGHT LOBBY:
  STRUCTURE TYPE:
  SUSPENDED WOODEN FLOOR:
  WINDOWS & DOORS DRAUGHTSTRIPPED %:
  SIDES SHELTERED:
  FLOOR TYPE:
  FLOOR AREA 1:
  FLOOR AREA 2:
  FLOOR AREA 3:
  UNDERFLOOR HEATING:
  ROOF TYPE:
  ROOF AREA 1 AND INSULATION THICKNESS:
  ROOF AREA 2 AND INSULATION THICKNESS:
  ROOF AREA 3 AND INSULATION THICKNESS:
  WALL TYPE 1:
  WALL TYPE 2:
  WALL TYPE 3:
  COMMENTS ON WALLS/EXTENSIONS:
  DOORS & % DOORS GLAZED:
  WINDOW TYPE FRAME ORIENTATION SIZE GAP OVERSHADING:
  WATER DISTRIBUTION LOSSES:
  WATER STORAGE LOSSES:
  SOLAR WATER HEATING:
  SUPPLEMENTARY SUMMER ELEC WATER HEATING:
  COMBI BOILER:
  WATER STORAGE VOLUME LTRS:
  TYPE OF WATER STORAGE INSULATION:
  WATER STORAGE INSULATION THICKNESS:
  CYLINDER THERMOSTAT:
  SEPARATE HOT WATER CONTROL:
  PRIMARY PIPEWORK INSULATED:
  NO. OF LIGHTS & CFL LIGHTS:
  HEATING SYSTEM CONTROLS:
  NO. OF CENTRAL HEATING PUMPS:
  OIL BOILER PUMP:
  GAS BOILER FLUE FAN:
  MAKE/MODEL BOILER:
  SECONDARY HEATING TYPE:
  FUELS USED FOR HEATING SYSTEMS:
  COMMENTS/ADDITIONAL DATA:

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