Title Page

  • Unit Number

  • Conducted on

  • Technician

Kitchen

  • Video of kitchen mechanical

  • Switch

  • Lights

  • Outlets

  • Faucet

  • Drains/Lines

  • Cabinets

  • Range

  • Anti tilt

  • Refrigerator

  • Dishwasher

  • Microwave

  • Disposal

  • Fire sprinkler head free from paint,dust,debri

  • Refrigerator

  • Microwave

  • Dishwasher

  • Range

Laundry

  • Video of laundry mechanical

  • Dryer

  • Dryer vent

  • Washer

  • Washer hose bib/lines

  • Washer drain

  • Shelves

  • Fire sprinkler head is free from paint,dust,debri

  • Washer model/serial

  • Dryer model/serial

Water Heater

  • Video of laundry mechanical

  • Water temperature

  • Prv

  • Unit valves

  • Water meter

  • Transmitter RF Signal

Livingroom

  • Video of living room mechanical

  • Front door

  • Switches

  • Outlets

  • Fan/Lights

  • Smoke Alarm

  • Window/Blinds

  • Screens

  • Patio Door

  • Patio Light/GFI

  • Fire sprinkler is free from paint,dust,debri

Bedroom

  • Video of bedroom mechanical

  • Door

  • Switches

  • Lights/Fan

  • Windows/Blinds

  • Smoke Alarm

  • Shelving

  • Fire sprinkler head is free from paint,dust,debri

Hall Bath

  • Video of bath mechanical

  • Doors

  • Lights/Exhaust Fans

  • Outlets/GFI

  • Vanity

  • Faucet

  • Mirror

  • Toilet

  • Towel bar/paper holder

  • Tub faucet

  • Shower head

  • Tub/shower

  • Closet/Shelves/Light

  • Fire sprinkler is free from paint,dust,debri

HVAC

  • Video of Hvac mechanical

  • Outdoor temperature

  • Indoor temperature

  • Cooling supply temperature

  • Heating supply temperature

  • Filter

  • All supply vents

  • Condenser labeled

  • Disconnect labeled

  • Condenser fastened to pad

  • High and low voltage wires correct and in conduit

  • Comments

Electrical panel

  • Is breaker panel labeled

  • Is outdoor breaker labeled

  • Technician signature

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.