CornerStone Builds LLC

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  Address

GENERAL INFORMATION

• Site Photo Exterior

  Media
• Site Location/Address
  Address

• Owner/Client

• Date

  Date

• Weather

  Media

BUILDING DATA (Exterior)

• Approximate Age

• General Appearance

  Good

  Fair

  Poor

• Number Of Stories

  Select 1 2 3 4 5

  • 1
  • 2
  • 3
  • 4
  • 5

• Roofing Material

  Composite

  Wood Shake

  Metal

  Other

• Exterior Covering

  Select Vinyl Wood Brick Stone Stucco Metal Other

  • Vinyl
  • Wood
  • Brick
  • Stone
  • Stucco
  • Metal
  • Other

• Basement

  Yes

  No

• Foundation Material

  Concrete Slab

  Block

  Stone

  Brick

  Other

• Rain Guttering

  Yes

  No

• Guttering Clear Of Debris

  Yes

  No

• Sprinkler System (Landscaping)

  Yes

  No

• Structure Heavily Shaded

  Yes

  No

• Location/Description

• Standing Water, Water Staining, Water Damage, Wood Rot/Structural Damage or Visible Mold on Exterior of Building

  Yes

  No

• Location and Description

BUILDING DATA (Interior)

• Wall And Ceiling Materials

  Select Sheetrock/Drywall Wood Paneling Plaster Other

  • Sheetrock/Drywall
  • Wood Paneling
  • Plaster
  • Other

• Floor Covering

  Select Carpet Wood Vinyl Tile Concrete Wood Subflooring Other

  • Carpet
  • Wood
  • Vinyl
  • Tile
  • Concrete
  • Wood Subflooring
  • Other

• HVAC System Installed

  Yes

  No

• HVAC Filters In Place And In Working Condition

  Yes

  No

• Leaks, Water Staining or Condensation Present On Or Around HVAC Unit, Ducts or Registers.

  Yes

  No

• Standing Water, Water Staining or Visible Mold Present Inside Building

  Yes

  No

• Location and Description

INTERIOR ENVIRONMENTAL CONDITIONS

• Location

Room

• Room

  Select Kitchen Living Room Den Bedroom Master Bedroom Master Bathroom Bathroom Closet Entryway Media Room Game Room Crawlspace Basement Attic HVAC Other Laundry Room Garage Outside Control Dining Room

  • Kitchen
  • Living Room
  • Den
  • Bedroom
  • Master Bedroom
  • Master Bathroom
  • Bathroom
  • Closet
  • Entryway
  • Media Room
  • Game Room
  • Crawlspace
  • Basement
  • Attic
  • HVAC
  • Other
  • Laundry Room
  • Garage
  • Outside Control
  • Dining Room

• Description

• Temperature

• R Humidity %

• Comments

Testing

• Sample Location/Type

Sample

• Area

  Select Kitchen Living Room Den Bedroom Master Bedroom Master Bathroom Bathroom Closet Entryway Media Room Game Room Crawlspace Basement Attic HVAC Other Laundry Room Garage Outside Control Dining Room

  • Kitchen
  • Living Room
  • Den
  • Bedroom
  • Master Bedroom
  • Master Bathroom
  • Bathroom
  • Closet
  • Entryway
  • Media Room
  • Game Room
  • Crawlspace
  • Basement
  • Attic
  • HVAC
  • Other
  • Laundry Room
  • Garage
  • Outside Control
  • Dining Room

• Location Description

• Type

  Spore Trap

  Tape

  Swab

Conclusion

• Elevated Levels of Mold Exist

  Yes

  No

  N/A

• Remediation Necessary

  Yes

  No

• Recommendations

• Notes & Comments

• Inspector Signature

  Sign

Site Photos

• Media

  Media