Report damp and mould Note: Questions marked by * are mandatory *This is a mandatory field. Your postcode *This is a mandatory field. Your address *This is a mandatory field. What type of property is your home? Please Select An Option Flat/apartmentHouseBungalow *This is a mandatory field. How many bedrooms? Please Select An Option 123456+ *This is a mandatory field. How many people live in the household? Please Select An Option 12345678910+ *This is a mandatory field. Please select the age ranges of people living in the household? 0-10 10-20 20-50 50-70 70+ *This is a mandatory field. Is this a new or previously reported case? New case Previously reported case *This is a mandatory field. Provide the date you first noticed the damp/mould *This is a mandatory field. Date reported (if reporting for the first time, provide today's date). Yes No *This is a mandatory field. Is there currently a leak in your home? *This is a mandatory field. Has there been a leak in your home within the last 12 months? Please provide further details of the leak (if applicable) *This is a mandatory field. What type of windows does your home have? Single glazed - all Single glazed - some Double glazed - all Double glazed - some Yes No *This is a mandatory field. Do the windows have trickle vents? *This is a mandatory field. Are they in working order? If no, have you reported a window repair? Please provide repair details (date reported, job number etc - if applicable) *This is a mandatory field. Do you leave the vents open? Yes No *This is a mandatory field. What type of heating does your home have? Please Select An Option Gas boilerStorage radiators Heat pumpCommunal heating *This is a mandatory field. How is your home's heating distributed? Please Select An Option Radiators - full Radiators - someElectric storage heaters *This is a mandatory field. Is your heating working? Yes No If no - provide details of the issue (how long for, have you previously reported this, job number etc) *This is a mandatory field. Do you use the heating? Yes No If no, why do you not use your heating? Please Select An Option CostWarm enough anywayFear of using gas/combustion Other If you selected 'other' above, please provide details. *This is a mandatory field. What temperature do you normally have the thermostat set at? Please Select An Option Below 65F / 18C 65-69F / 18-20C70-74F / 21-23C75-79F / 24-26C80F / 27C or above *This is a mandatory field. Do you have a kitchen extractor fan? Yes No If yes, what type of fan? Please Select An Option Window fanWall fanCeiling fanCooker extractor fan *This is a mandatory field. What type of bathroom extractor fan do you have? Please Select An Option Window fanWall fanCeiling fanUnsure Yes No *This is a mandatory field. Do you have a whole house ventilation system? *This is a mandatory field. Are the ventilation units working? If you answered no above, please provide details. *This is a mandatory field. Do you use/leave the ventilation on? Yes No If no, why? Please Select An Option CostNoiseOther *This is a mandatory field. How many rooms does your home have? (Include hallway/landing areas as a room) Please Select An Option 12345678910+ *This is a mandatory field. How many rooms are affected by damp or mould? Please Select An Option 12345678910+ *This is a mandatory field. Are the walls affected? Yes No Please share any photos if possible. *This is a mandatory field. Are you a leaseholder? Yes No Property age (if known) Dwelling UPRN ( if known) Building UPRN (if known) Procurement Report - Luke House Lift Replacement-1.1 LH.pdf [pdf] 3MB
