Technical Exhibit F - G4 Facility Inspection Checklist.pdf
PDF 177 KB Posted
- Solicitation number
- W91ZLK-25-R-0002
About this file
This is a G4 Facility Inspection Checklist form used to document comprehensive facility inspections. The checklist covers 14 major inspection categories: General Exterior, Roof, Parking Lot, General Interior, Plumbing, Electrical System, Mechanical Room, Supply Room, Safety, Safety Equipment, Fire Prevention Monitor, Custodial/Housekeeping, Physical Security, and Facility-Specific Items.
The form requires documentation of building details including date of inspection, building number, year built, square footage, number of open fire deficiencies, and ISR rating. Each section contains detailed inspection items that must be marked Yes/No/N/A and assigned service order and work order numbers for any "Yes" responses indicating issues. The checklist emphasizes safety and maintenance aspects including fire prevention, electrical systems, structural integrity, cleanliness, security features, and proper documentation. Any urgent failures must be immediately reported to the G4 CBC Facility & Infrastructure Division Chief. The completed checklist must be stored in the G4 MS Teams Repository and requires review by a government G4 lead.
View the file
Other files
Show 40 more
Latest 50 of 51 listed here. See the rest on GovTribe.
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Date Inspected:________________ Inspected by: ___________________
Building Number:_______________ Year Built:______________ Sq. Ft.:__________
Number of Open Fire Deficiencies: ___________ ISR Rating at time of Inspection:______________
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
1.14
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
2.1 Can roof be accessed from inside the building?
2.2 Visual inspection or walk-thru inspection?
2.3
2.4
2.5
2.6
2.7
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
3.10
Other:
Other:
Are paved surfaces in good condition?
2.0 ROOF:
3.0 PARKING LOT:
Debris on Roof?
Roof drains free of debris?
Physical damage?
G4 FACILITY INSPECTION CHECKLIST
Are there areas of standing water around the facility that will not dry?
Are stairs and handrails in good repair and fastened securely?
Are exterior doors free of damage and operate properly?
Are exterior walls free from cracks or other damages?
Are windows free from cracks or broken panes?
Has vegetation been cut back from the building?
Is the building free from signs of exterior damage?
Are exterior lights in working order?
Is the landscaping properly maintained?
1.0 GENERAL EXTERIOR:
Are hose bibs/exterior plumbing in good working order?
Are gutters & downspouts in good condition?
Do they route water away fromthe foundation of the facility?
Are bay/overhead doors in good condition and good working order?
Type of roof?
Is parking lot free of trash and debris?
Are there any pot holes larger than 6" in diameter?
Are any directional signs damaged, missing, or illegible?
Are any organizational signs damaged, missing, or illegible?
Are parking lanes clearly marked?
Does the parking provide adequate lighting?
Does the existing parking lot lighting work properly?
Are pedestrians offered a safe walkway?
Other:
INSTRUCTIONS:
1. The inspector(s) must review each question below and ensure each question is fully answered. Any question(s) that have a response “YES” must have associated inspections notes and service order and/or work order.
2. The facility inspection checklist is NOT complete if there are blanks on the checklist, and if there is missing applicable service order or work order numbers.
3. Any urgent failures/findings must be immediately reported to the G4 CBC Facility & Infrastructure Division Chief.
4. The Facility Inspection Checklist should be stored in the G4 MS Teams Repository.
Revised 3/27/23 1
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13 Does office need updated (i.e., wrong information, not legible. Etc . ) 4.14
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
5.1
5.2
5.3
5.4
5.5
5.6
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
6.1
6.2
6.3
6.4
6.5
6.6
6.7
6.8
6.9
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
7.1
7.2
7.3
7.4
7.5
7.6
7.7
7.8
Are touchless faucets and drains operational and not leaking?
Are toilets operational and not leaking?
Do P-Traps show signs of leaking?
Other:
6.0 ELECTRICAL SYSTEM
Are all electrical panels free from evidence of burning?
Have all electrical circuits been identified?
Have GFI outlets been provided on circuits in proximity to water?
Are interior walls free from cracks or other damages?
Is the ceiling in good repair? Are drop ceiling panels clean?
Do the drop ceiling panels show signs of roof leaks? (Spots/discoloration )
Are compressor motors cool to the touch?
5.0 PLUMBING (excludes lab areas)
Are manual faucets and drains operational and not leaking?
Are building custodian cards posted in the front the building?
Are other finishes in good condition?
Are there signs of insect/rodent activity?
Are shop floors in good condition and free from debris?
Is interior lighting adequate and in good working condition?
Is trash overflowing?
Is storage restricted to designated areas?
Are all electrical panels secured?
Is a 3' clearance provided around all electrical panels?
Are all electrical rooms free from combustible storage?
Are all electrical panels cool to the touch?
4.0 GENERAL INTERIOR:
Are boiler/furnace rooms kept locked?
Is a 3' clearance provided around all heating equipment?
Are boiler/furnace rooms kept free from combustible storage?
Are air compressor automatic drains functioning properly?
Is mechanical room lighting adequate and in good working order?
Other:
Are water fountains operational?
Is there a lock-out/tag-out procedure in place?
Other:
Is the flooring in good condition?
Are the wall coverings/paint in good condition?
Other:
7.0 MECHANICAL ROOM
Are all pump motors cool to the touch?
Revised 3/27/23 2
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
8.1
8.2
8.3
8.4
8.5
8.6
8.7
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
9.1
9.2
9.3
9.4
9.5
9.6
9.7
9.8
9.9
9.10
9.11
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
10.1
10.2
10.3
10.4
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
11.1
11.2
11.3
11.4
11.5
11.6
11.7
11.8
11.9
11.10
11.11
11.12
11.13
Are all valves supplying water or air to the system open?
Is the alarm panel to the fire department operational?
Is the sprinkler system tested and documented?
Are spare sprinkler heads available in the building?
Is the building equipped with a fire detection system?
Does the system protect the entire building?
Does the system provide an alarm signal in the building?
Is the alarm system tested and documented?
10.0 SAFETY EQUIPMENT
11.0 FIRE PREVENTION MONITOR
Is the building equipped with an automatic sprinkler system?
Is the main sprinkler control valve accessible?
Are exits unlocked and operational?
Are working emergency lights provided in the building?
Are evacuation diagrams posted throughout the building?
Other:
Are all AEDs properly stored, labeled, located, and operational?
Are all Fire extinguishers properly inspected, labeled, located, and operational?
Are all Eye Wash Stations properly labeled, located, and operational?
Other:
Has the Supply Room - Supply List being utilized?
Other
Is supply consolidated into (1) room and not spread across the building?
Are supply rooms secured by lock?
Does the supply door have a Supply Room sign with a POC?
Is supply labeled, organized, and material properly stored/stacked on shelving?
8.0 SUPPLY ROOM
Are fire hydrants accessible?
Are sprinkler/standpipe connections accessible?
Are sprinkler/standpipe connections clearly marked?
Are combustible materials stored away from the building?
Are stairs and handrails in good repair and fastened securely?
Are there tripping hazards that need marking or to be eliminated?
Has flammable storage been limited to designated areas?
Are all exits and travel paths identified and illuminated with EXIT signs?
Is there adequate supplies or does supplies need to be ordered?
9.0 SAFETY
Any mold visible through-out the building?
Are travel paths leading to exits free of obstructions?
Revised 3/27/23 3
11.14
11.15
11.16
11.17
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
12.1
12.2
12.3
12.4
12.5
12.6
12.7
12.8
12.9
12.10
12.11
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
13.1
13.2
13.3
13.4
13.5
13.6
YES NO N/A
SERVICE
ORDER #
WORK
ORDER #
14.1
14.2
14.3
14.4
14.5
14.6
14.7
14.8
14.9
14.10
14.11
14.12
14.13
Any signs of unusual or abnormal activity?
Other:
14.0 INSPECTION ITEMS UNIQUE TO FACILITY
Is the building free of pests droppings and dead pests?
Are fans and grills free of dust?
12.0 CUSTODIAL/ HOUSEKEEPING
Do all extinguishers have a current inspection tag?
Other:
Are portable fire extinguishers present & operational?
Are all extinguishers inspected on a monthly basis and documented?
13.0 PHYSICAL SECURITY
FIRE PREVENTION MONITOR "Cont'd"
Are entryway/lobby areas clean and presentable?
Are conference rooms being maintained?
Are central recycling areas clean and being policed?
Is trash being regularly removed?
Are floors clean (no debris or stains)?
Are bathrooms clean?
Do bathrooms have soap and paper towels?
Are Interior windows clean (no dirt or smears) Other:
Are the main entry door(s) locking mechanism operational?
Are back door(s) and side door(s) locking mechanism operational?
Does the building have controlled access (i.e., CAC enabled)?
Any signs of forced entry?
Revised 3/27/23 4
Name: Title: Date:
This inspection was reviewed by the following government G4 lead:
15.0 PROVIDE ADDITIONAL CONTEXT FOR "YES" ITEMS NOTED ABOVE
Inspection# Room / Location Corrective Action(s) Needed
Revised 3/27/23 5
Sheet1
File details come from the government source that posted it. Updated .