Exhibit B_eMH FHM InspectionChecklist.pdf

PDF 1 MB Posted

Attached to
Army Housing Inspection Federal contract opportunity
Solicitation number
W9124J-23-R-HOUS
Issued by
Department of the Army Materiel Command Mission and Installation Contracting Command Fort Sam Houston

About this file

This solicitation is for housing inspection services to support the Department of the Army. Required services include conducting inspections of all Army-owned, leased, and privatized family and unaccompanied housing units worldwide utilizing a provided checklist. A total of 25,000 housing units must be inspected by October 2023. The solicitation involves substantial geographic considerations due to the worldwide scope of work, which will require understanding various host nation laws and regulations, recruiting eligible personnel, and coordinating international travel and compliance with status of forces agreements. Other military departments, including the Air Force, Navy, and Marine Corps, are also procuring similar inspection services. The Air Force awarded a task order for these services under an existing IDIQ contract held by Bureau Veritas.

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Other files for this federal contract opportunity

Other files attached to Army Housing Inspection, newest first.
File Type Posted
Special Notice-2 23-R-HOUS Final (002).pdf PDF
Exhibit B_ eMH - UH Inspection Checklist - EHS.pdf PDF
Exhibit A_By Location Housing Inventory Listing Rye-Changes.xlsx XLSX spreadsheet
Special Notice 23-R-HOUS.pdf PDF
Special Notice 23-R-HOUS PWS.pdf PDF

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Text version

Gov Owned, Privatized, and Leased Inspection Checklist

Property Type Inspection Type

General Safety Yes No N/A

Lead Based Paint

If you answered "No" to any question above, please provide details:

If you answered "No" to any question above, please provide details:

Radon

If you answered "No" to any question above, please provide details:

Yes No UNK N/A

Yes No UNK N/A

Measurements and Readings (More than one reading may need to be taken to enable a representative reading for level)

Water

Mold/Moisture Control

Yes No

Pest Management

If you answered "No" to any question above, please provide details:

Yes No UNK

Yes No

Asbestos

If you answered "No" to any question above, please provide details:

If you answered "No" to any question above, please provide details:

Yes No UNK N/A

If you answered "No" to any question above, please provide details:

HVAC

Yes No N/A sunderwood Rectangle

HVAC (Continued)

If you answered "No" to any question above, please provide details:

Yes No N/A

Fire Sprinklers Yes No N/A

If you answered "No" to any question above, please provide details:

The condition of the unit is clean, with no visible damage other than the items noted on this form.

Component Rating Condition Codes

Exterior

Kitchen

Living Room/ Dining Room/ Den

Laundry Room/ Mechanical Room/ Basement/ Sunroom

Bedrooms

Bedrooms

Bathrooms

Bedroom Location Description Bathroom Location Description Bathrooms

Follow-up Actions

Inspection Comments

Overall Unit Inspection Results

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label:
hvac:
exhaustFans: Are all exhaust fans in working order (Kitchen, Bathroom, Laundry, etc.)?
dryerVent: Is dryer vent in working order?
heatingSystem: Is heating system in working order?
airConditioning: Is air conditioning system in working order?
workingHumidifier: Is the humidifier/dehumidifier in working order?
visibleDamage: Is the unit free of any visible damage to or leaks in ducts (No visible gaps, tears, or holes in ducts)?
plumbingInsulated: Are HVAC and plumbing components and systems properly insulated (No signs of condensation or rust)?
filterChanged: Has HVAC filter been changed per installation policy?
followUpActions:
none: None
asbestos: Asbestos
leadBasedPaint: Lead Based Paint
otherEnvironmentalHazards: Other Environmental Hazards
moldWaterInstrusionDampness: Mold/Water Intrusion/Dampness
submittedWorkOrder: Submitted Work Order
notifiedChainOfCommand: Notified Chain of Command
reportedToPrivatizedManagement: Reported to Privatized Management
lifeHealthAndSafety: Life, Health, and Safety
createdServiceLog: Created Service Log
unitInspectionResult:
pass: Pass
passNonHLS: Pass with non-Health and Safety Condition
fail: Fail
commanderWaiver: Installation/Garrison Commander Waiver
commanderWaiverCheck:
yes: Yes
no: No
commanderWaiverJustification: Installation/Garrison Commander Waiver
commander~Signature: Installation/Garrison Commander Signature
measurementsGridHeader:
outdoorTemp: Outdoor Readings
mainFloor: Main Floor Readings
secondFloor: Second Floor Readings
thirdFloor: Third Floor / Basement Readings
crawlSpace: Crawl Space Readings
attic: Attic Readings
comments: Comments
temperature: Temperature
range:
temperature: 68° F - 80° F
dewPoint: < 55° F
relativeHumidity: 30% - 50%
temperature_comfort: (per comfort)
dewPoint: Dew Point
relativeHumidity: Relative Humidity
moldMoistureControl:
visibleMold: Is the unit free of visible mold,water damages/stains, and persistent dampness/moisture on all surfaces and surface coverings?
visibleLeaks: Is the unit free of any visible signs of leaks at plumbing fixtures or appliances?
mustyOdor: Is the unit free of any strong musty odors?
drainageSystem: Does the unit have a drainage system or does the water drain away from the structure?
standingWater: Is the unit free of any visible standing water against the foundation?
pestManagement:
pestFree: Does the unit appear to be free of pests?
pestManagementMethods: Are there pest management methods in place to ensure unit is free of infestation?
asbestos:
inventoryAssessment: Does the unit have an asbestos inventory assessment?
visibleDamage: Is potential asbestos containing material free of visible damage (walls, ceilings, fibrous pipe, insulation, tile flooring, etc.)?
water:
sinkFaucets: Have sink faucets been sampled for lead in drinking water or are they scheduled for sampling?
consumerConfidenceReport: Does the resident have access to the Consumer Confidence Report for drinking water and is the water supply tested in accordance with the Safe Drinking Water Act and state regulations (As applicable/US locations only)?
otherUnits: Have other units in the building/neighborhood been tested for lead in water?
potableWater: Does the unit have potable water?
visualDiscoloration: Is the tap water free of any visual discoloration or oily consistency?
odorFree: Is tap water free of any odors?
adequatePressure: Does the unit have adequate water pressure?
hotWaterTemperature: Is the water temperature less than 120 degrees Fahrenheit?
filtrationSystem: If the unit has a water filtration system have the filters been changed according to the manufacturer's guidelines?
fireSprinklers:
controlValves: Are the fire sprinkler control valve(s) open?
freeOfPaint: Are the fire sprinkler heads free of paint or convering?
effectiveSpray: Are the fire sprinkler effective spray area free of any obstructions (i.e. anything hanging from a sprinkler head)?
sprinklersInspected: Have the fire sprinklers been inspected according to the regulations?
componentRating:
good:
code: G
value: Good
description: Like new, fully functional. No potential LHS issues.
fair:
code: F
value: Fair
description: Functional, minor or cosmetic damage only. No potential LHS issues.
poor:
code: P
value: Poor
description: Not functional. Requires repair.
lhs:
code: LHS
value: Life/Health/Safety
description: Presents potential LHS hazard. Requires repair and/or further inspection.
na:
code: NA
value: Not Applicable
description: Component is not present in room.
conditionCode:
worn:
code: WRN
description: Component is serviceable but worn and near end of life
needsPaint:
code: NP
description: Needs paint
clean:
code: CLN
description: Needs to be cleaned
missingItem:
code: MIS
description: Missing item or part
replace:
code: REP
description: Needs to be replaced
scratched:
code: SCR
description: Scratched
repair:
code: NR
description: Needs repair
stain:
code: STN
description: Stains/stained
exterior:
doorBell: Door Bell
exteriorDoors: Front/Back Exterior Doors
stormDoors: Front/Back Storm Doors
windowsGround: Windows/Screens Ground Floor
windowsAboveGround: Windows/Screens Above Ground Floor
stucco: Stucco
siding: Siding
brickMasonry: Brick/Masonry
roof: Roof
flashing: Flashing
soffitFascia: Soffit/Fascia
ventPipes: Vent Pipes
outsideDrain: Outside Draining (Gutters/Downspouts)
landscaping: Landscaping
foundation: Visible Foundation
dripLine: Drip Line (Bare Soil)
porch: Porch/Patio
balcony: Balcony/Deck
fence: Fence, Gate, and Latches
carport: Carport/Garage/Driveway
lighting: Exterior Lighting (operational)
electricalOutlet: Electrical Outlet(s) GFCI Protected
hoseBib: Exterior Hose Bib
stairs: Stairs/Stairwells
hvac: HVAC
waterHeater: Water Heater
kitchen:
doors: Kitchen Doors
ceiling: Ceiling
flooring: Flooring
walls: Walls
windows: Windows/Blinds/Sills/Sashes
pantry: Pantry Door/Shelving
cabinets: Cabinet Doors/Drawers/Shelves
counterTops: Counter Tops and Sink(s)
caulk: Caulk
microwave: Microwave
sinkFaucets: Sinks and Faucets (hot/cold)
dishwasher: Dishwasher (operational)
garbageDisposal: Garbage Disposal (operational)
refrigerator: Refrigerator
rangeOven: Range/Oven
applianceLightBulbs: Appliance Light Bulbs (operational)
ventilationRange: Ventilation (Range)
gfciOutlets: GFCI Protected Electric Outlet(s)
smokeDetectors: Smoke Detectors
carbonMonoxideDetectors: Carbon Monoxide Detectors
lighting: Lighting (Fixtures and Bulbs)
livingGroup:
interiorDoors: Interior Doors
stairs: Stairs
handrails: Handrails
ceiling: Ceiling
vinylFlooring: Vinyl Flooring
tileFlooring: Tile Flooring
carpetFlooring: Carpet Flooring
woodFlooring: Wood/Laminate Flooring
wallsTrim: Walls and Trim
windows: Windows/Sills/Sashes
windowBlinds: Window Blinds/Shutters/Shades
lighting: Lighting (Fixtures and Bulbs)
gfciOutlets: GFCI Protected Switch(es) and Outlet(s)
fireplace: Fireplace
fireExtinguisher: Fire Extinguisher
ceilingFans: Ceiling Fans
smokeDetectors: Smoke Detectors
carbonMonoxideDetectors: Carbon Monoxide Detectors
laundryGroup:
interiorDoors: Interior Doors
stairs: Stairs
handrails: Handrails
ceiling: Ceiling
vinylFlooring: Vinyl Flooring
tileFlooring: Tile Flooring
carpetFlooring: Carpet Flooring
woodFlooring: Wood/Laminate Flooring
wallsTrim: Walls and Trim
windows: Windows/Sills/Sashes
windowBlinds: Window Blinds/Shutters/Shades
lighting: Lighting (Fixtures and Bulbs)
gfciOutlets: GFCI Protected Switch(es) and Outlet(s)
fireplace: Fireplace
fireExtinguisher: Fire Extinguisher
ceilingFans: Ceiling Fans
exhaustFans: Exhaust Fans
hvacSystem: HVAC System(s)
smokeDetectors: Smoke Detectors
carbonMonoxideDetectors: Carbon Monoxide Detectors
washingSupplyDrain: Washing Machine Supply and Drain
dryerVentPipe: Clothes Dryer Vent Pipe
bedroom1:
description: Bedroom 1
bedroom2:
description: Bedroom 2
bedroom3:
description: Bedroom 3
bedroom4:
description: Bedroom 4
bedroom5:
description: Bedroom 5
bathroom1:
description: Bathroom 1
bathroom2:
description: Bathroom 2
bathroom3:
description: Bathroom 3
bathroom4:
description: Bathroom 4
bathroom5:
description: Bathroom 5
bedGroup:
interiorDoors: Bedroom Door
ceiling: Ceiling
flooring: Flooring
wallsTrim: Walls and Trim
windows: Windows/Sills/Sashes
windowBlinds: Window Blinds/Shutters/Shades
lighting: Lighting (Fixtures and Bulbs)
switchesOutlets: Switches and Outlets
ceilingFans: Ceiling Fans
hvacRoom: HVAC (heaters/AC units/radiators/vents)
closet: Closet
smokeDetectors: Smoke Detectors
carbonMonoxideDetectors: Carbon Monoxide Detectors
bathGroup:
interiorDoors: Bathroom Door
ceiling: Ceiling
flooring: Flooring
wallsTrim: Walls and Trim
windows: Windows/Sills/Sashes
windowBlinds: Window Blinds/Shutters/Shades
lighting: Lighting (Fixtures and Bulbs)
gfciSwitchesOutlets: GFCI Protected Switches and Outlets
closet: Closet
shelves: Shelves
mirror: Mirror
towelRacks: Towel Racks
vanityCounterTop: Vanity Counter Top
vanityHardware: Vanity Knobs/Pulls
sinkFaucets: Sink and Faucets (hot/cold)
toilet: Toilet (operation)
caulk: Caulk - Tub/Shower
tubShowerFaucets: Faucets (hot/cold) - Tub/Shower
tubShowerDrain: Tub/Shower Drain
bathroomHardware: Bathroom Hardware (tightened)
ventilationExhaustFan: Ventilation/Exhaust Fans
inspectUnit:
installationName: Installation:
unitAddress: Unit Address:
stateProvidence: State/Providence:
countryName: Country:
yearBuilt: Year Built (YYYY):
rpuid: RPUID:
housingRep~Name: Housing Rep Name:
housingRep~Signature: Housing Rep Signature:
housingRepPhone: Housing Rep Phone:
housingRepEmail: Rep Email:
privManagement~Name: Priv Management Name:
privManagement~Signature: Priv Management Signature:
resident~Name: Resident Name:
resident~Signature: Resident Signature:
dateOfAssessment: Date of Inspection:
inspectionNumber: Inspection Number:
generalSafety:
egressEmergency: Does every habitable room meet local/building/occupancy ordinance requirements for egress for emergency escape and rescue opening?
windowCoverings: Does unit have cordless window coverings or tension/hold-down devises on corded window coverings in accordance with 22 Feb 2018 DoD Memo, Mitigation of Risks Posed by Window Coverings with Accessible Cords?
unitOpeningControls: Does the unit have opening controls or limits on all windows above the ground floor in accordance with 10 USC 2879(a)?
accessOpenCloseLockProperly: Do all exterior doors and windows open/close/lock properly?
fireAndEmergencyExitsInWorkingOrder: Are all Fire Doors and Emergency Exits unlocked and in working order?
securedHandAndGuardRails: Are there properly secured handrails and guard rails on all interior and exterior stairs and stairwells?
furnishingsEquipmentAnchored: Are all government or privatized housing provided free-standing furnishings and equipment properly anchored as required?
workingSmokeAlarms: Are smoke alarms in working order?
workingSmokeAlarmsManDate: Manufacture Date:
fireAlarmControlPanel: Is the existing smoke detector and fire sprinkler system connected to the Fire Alarm Control Panel and Installation Fire Response System?
workingCarbonMonoxideDetectors: Are Carbon Monoxide Detectors in working order and present on every floor outside of habitable sleeping areas?
workingCarbonMonoxideDetectorsManDate: Manufacture Date:
freeOfGasOrPropaneHazard: Is the unit free of any identified gas or propane hazards ("rotten eggs" smell, disconnected gas appliances, or gas equipment, etc.)?
workingInteriorGfciOutlets: Are interior GFCI outlets (within six feet of a water source) working?
workingExteriorGfciOutlets: Are exterior GFCI outlets working?
exteriorGarageBasementProtectedGfciOutlets: Are all exterior, garage, and unfinished basement receptacles protected by GFCIs?
freeOfElectricalHazards: Is the unit free of any identified electrical hazards (tripped breakers that won't reset, overloaded outlets, scorch marks on outlets, etc.)?
leadBasedPaint:
builtAfter1978: Is the unit built after 1978 and is the OCONUS unit located where lead-based paint is not available in the local economy? If yes, go to next section.
leadPaintInspection: Was a lead based paint inspection or risk assessment conducted on the unit?
leadFreeCertification: Does the unit have a State issued Lead Free Certification or an approved Lead-Based Paint inspection that found no interior or exterior lead-based paint? If yes, go to next section.
visiblePaintDamage: Is the unit free of any visible signs of damaged, cracked, peeling painted surfaces dust or debris, interior or exterior? (HUD Visual Assessment Training required to answer)
radon:
previousTesting: Has there been previous testing for Radon?
previousTestingInspectionDate: If yes, Date:
previousTestingInspectionReading: Reading:
unitRetested: Has the unit been retested since being renovated, resided, or having a window/door or HVAC replacement?
mitigationSystem: If present, is the Radon Mitigation system in working order?
mitigationSystemDate: Date of last system inspection:
header:
exterior:
component: Component
rating: Rating
condition: Condition
comments: Comments
kitchen:
component: Component
rating: Rating
condition: Condition
comments: Comments
livingGroup:
component: Component
roomType1:
rating: Rating
condition: Condition
roomType2:
rating: Rating
condition: Condition
roomType3:
rating: Rating
condition: Condition

comments: Comments

laundryGroup:
component: Component
roomType1:
rating: Rating
condition: Condition
roomType2:
rating: Rating
condition: Condition
roomType3:
rating: Rating
condition: Condition

comments: Comments

bedGroup:
component: Component
bedroom1:
rating: Rating
condition: Condition
bedroom2:
rating: Rating
condition: Condition
bedroom3:
rating: Rating
condition: Condition
bedroom4:
rating: Rating
condition: Condition
bedroom5:
rating: Rating
condition: Condition

comments: Comments

bathGroup:
component: Component
bath1:
rating: Rating
condition: Condition
bath2:
rating: Rating
condition: Condition
bath3:
rating: Rating
condition: Condition
bath4:
rating: Rating
condition: Condition
bath5:
rating: Rating
condition: Condition

comments: Comments

hvac:
dryerVent: Off
exhaustFans: Off
heatingSystem: Off
airConditioning: Off
workingHumidifier: Off
visibleDamage: Off
plumbingInsulated: Off
filterChanged: Off
comments:
followUpActions:
none: Off
asbestos: Off
leadBasedPaint: Off
otherEnvironmentalHazards: Off
moldWaterInstrusionDampness: Off
sumittedWorkOrder: Off
notifiedChainOfCommand: Off
reportedToPrivatizedManagement: Off
lifeHealthAndSafety: Off
createdServiceLog: Off
unitInspectionResult: Off
commanderWaiver: Off
commanderWaiverJustification:
comments:
commander~Name:
commander~Date:
unitInspectionResults:
comments:
temperature:
outdoor:
mainFloor:
secondFloor:
thirdFloor:
crawlSpace:
attic:
comments:
dewPoint:
outdoor:
mainFloor:
secondFloor:
thirdFloor:
crawlSpace:
attic:
comments:
relativeHumidity:
outdoor:
mainFloor:
secondFloor:
thirdFloor:
crawlSpace:
attic:
comments:
moldMoistureControl:
visibleMold: Off
visibleLeaks: Off
mustyOdor: Off
drainageSystem: Off
standingWater: Off
comments:
pestManagement:
pestFree: Off
pestManagementMethods: Off
comments:
asbestos:
inventoryAssessment: Off
visibleDamage: Off
comments:
water:
sinkFaucets: Off
consumerConfidenceReport: Off
otherUnits: Off
potableWater: Off
visualDiscoloration: Off
odorFree: Off
adequatePressure: Off
hotWaterTemperature: Off
filtrationSystem: Off
comments:
fireSprinklers:
controlValves: Off
freeOfPaint: Off
effectiveSpray: Off
sprinklersInspected: Off
comments:
exterior:
doorBell:
rating: [ ]
condition: [ ]
comments:
exteriorDoors:
rating: [ ]
condition: [ ]
comments:
stormDoors:
rating: [ ]
condition: [ ]
comments:
windowsGround:
rating: [ ]
condition: [ ]
comments:
windowsAboveGround:
rating: [ ]
condition: [ ]
comments:
stucco:
rating: [ ]
condition: [ ]
comments:
siding:
rating: [ ]
condition: [ ]
comments:
brickMasonry:
rating: [ ]
condition: [ ]
comments:
roof:
rating: [ ]
condition: [ ]
comments:
flashing:
rating: [ ]
condition: [ ]
comments:
soffitFascia:
rating: [ ]
condition: [ ]
comments:
ventPipes:
rating: [ ]
condition: [ ]
comments:
outsideDrain:
rating: [ ]
condition: [ ]
comments:
landscaping:
rating: [ ]
condition: [ ]
comments:
foundation:
rating: [ ]
condition: [ ]
comments:
dripLine:
rating: [ ]
condition: [ ]
comments:
porch:
rating: [ ]
condition: [ ]
comments:
balcony:
rating: [ ]
condition: [ ]
comments:
fence:
rating: [ ]
condition: [ ]
comments:
carport:
rating: [ ]
condition: [ ]
comments:
lighting:
rating: [ ]
condition: [ ]
comments:
electricalOutlet:
rating: [ ]
condition: [ ]
comments:
hoseBib:
rating: [ ]
condition: [ ]
comments:
stairs:
rating: [ ]
condition: [ ]
comments:
hvac:
rating: [ ]
condition: [ ]
comments:
waterHeater:
rating: [ ]
condition: [ ]
comments:
kitchen:
doors:
rating: [ ]
condition: [ ]
comments:
ceiling:
rating: [ ]
condition: [ ]
comments:
flooring:
rating: [ ]
condition: [ ]
comments:
walls:
rating: [ ]
condition: [ ]
comments:
windows:
rating: [ ]
condition: [ ]
comments:
pantry:
rating: [ ]
condition: [ ]
comments:
cabinets:
rating: [ ]
condition: [ ]
comments:
counterTops:
rating: [ ]
condition: [ ]
comments:
caulk:
rating: [ ]
condition: [ ]
comments:
microwave:
rating: [ ]
condition: [ ]
comments:
sinkFaucets:
rating: [ ]
condition: [ ]
comments:
dishwasher:
rating: [ ]
condition: [ ]
comments:
garbageDisposal:
rating: [ ]
condition: [ ]
comments:
refrigerator:
rating: [ ]
condition: [ ]
comments:
rangeOven:
rating: [ ]
condition: [ ]
comments:
applianceLightBulbs:
rating: [ ]
condition: [ ]
comments:
ventilationRange:
rating: [ ]
condition: [ ]
comments:
gfciOutlets:
rating: [ ]
condition: [ ]
comments:
smokeDetectors:
rating: [ ]
condition: [ ]
comments:
carbonMonoxideDetectors:
rating: [ ]
condition: [ ]
comments:
lighting:
rating: [ ]
condition: [ ]
comments:
livingGroup:
header:
roomType1:
selection: [ ]
roomType2:
selection: [ ]
roomType3:
selection: [ ]
interiorDoors:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

stairs:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

handrails:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

ceiling:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

vinylFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

tileFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

carpetFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

woodFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

wallsTrim:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

windows:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

windowBlinds:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

lighting:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

gfciOutlets:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

fireplace:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

fireExtinguisher:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

ceilingFans:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

smokeDetectors:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

carbonMonoxideDetectors:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

laundryGroup:
header:
roomType1:
selection: [ ]
roomType2:
selection: [ ]
roomType3:
selection: [ ]
interiorDoors:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

stairs:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

handrails:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

ceiling:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

vinylFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

tileFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

carpetFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

woodFlooring:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

wallsTrim:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

windows:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

windowBlinds:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

lighting:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

gfciOutlets:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

fireplace:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

fireExtinguisher:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

ceilingFans:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

exhaustFans:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

hvacSystem:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

smokeDetectors:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

carbonMonoxideDetectors:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

washingSupplyDrain:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

dryerVentPipe:
roomType1:
rating: [ ]
condition: [ ]
roomType2:
rating: [ ]
condition: [ ]
roomType3:
rating: [ ]
condition: [ ]

comments:

bedroom1:
description:
bedroom2:
description:
bedroom3:
description:
bedroom4:
description:
bedroom5:
description:
bathroom1:
description:
bathroom2:
description:
bathroom3:
description:
bathroom4:
description:
bathroom5:
description:
groupHeader:
bedGroup:
bedroom1: Bedroom 1
bedroom2: Bedroom 2
bedroom3: Bedroom 3
bedroom4: Bedroom 4
bedroom5: Bedroom 5
bathGroup:
bath1: Bathroom 1
bath2: Bathroom 2
bath3: Bathroom 3
bath4: Bathroom 4
bath5: Bathroom 5
bedGroup:
interiorDoors:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
ceiling:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
flooring:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
wallsTrim:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
windows:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
windowBlinds:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
lighting:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
switchesOutlets:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
ceilingFans:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
hvacRoom:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
closet:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
smokeDetectors:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]
carbonMonoxideDetectors:
bedroom1:
rating: [ ]
condition: [ ]
bedroom2:
rating: [ ]
condition: [ ]
bedroom3:
rating: [ ]
condition: [ ]
bedroom4:
rating: [ ]
condition: [ ]
bedroom5:
rating: [ ]
condition: [ ]

comments:

bathGroup:
interiorDoors:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
ceiling:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
flooring:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
wallsTrim:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
windows:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
windowBlinds:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
lighting:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
gfciSwitchesOutlets:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
closet:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
shelves:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
mirror:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
towelRacks:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
vanityCounterTop:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
vanityHardware:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
sinkFaucets:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
toilet:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
caulk:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
tubShowerFaucets:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
tubShowerDrain:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
bathroomHardware:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]
ventilationExhaustFan:
bath1:
rating: [ ]
condition: [ ]
bath2:
rating: [ ]
condition: [ ]
bath3:
rating: [ ]
condition: [ ]
bath4:
rating: [ ]
condition: [ ]
bath5:
rating: [ ]
condition: [ ]

comments:

documentId:
templateIdentifier: InspectionBlankChecklist v2.01
inspectUnit:
installationName:
unitAddress:
stateProvidence:
countryName:
yearBuilt:
rpuid:
housingRepPhone:
housingRepEmail:
propertyType: [ ]
inspectionReason: [ ]
dateOfAssessment:
inspectionNumber:
generalSafety:
egressEmergency: Off
windowCoverings: Off
unitOpeningControls: Off
accessOpenCloseLockProperly: Off
furnishingsEquipmentAnchored: Off
workingSmokeAlarmsManDate:
workingSmokeAlarms: Off
workingCarbonMonoxideDetectorsManDate:
workingCarbonMonoxideDetectors: Off
workingInteriorGfciOutlets: Off
workingExteriorGfciOutlets: Off
comments:
fireAndEmergencyExitsInWorkingOrder: Off
securedHandAndGuardRails: Off
fireAlarmControlPanel: Off
freeOfGasOrPropaneHazard: Off
freeOfElectricalHazards: Off
exteriorGarageBasementProtectedGfciOutlets: Off
leadBasedPaint:
builtAfter1978: Off
leadPaintInspection: Off
leadFreeCertification: Off
visiblePaintDamage: Off
comments:
radon:
previousTesting: Off
previousTestingInspectionDate:
previousTestingInspectionReading:
unitRetested: Off
mitigationSystemDate:
comments:
mitigationSystem: Off
inspectUnit_housingRep~Date:
inspectUnit_privManagement~Date:
inspectUnit_resident~Date:
inspectUnit_housingRep~Name:
inspectUnit_privManagement~Name:
inspectUnit_resident~Name:

File details come from the government source that posted it. Updated .