Title Page
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Conducted on
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Prepared by
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Personnel on duty in area
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Location being inspected
- A1
- A2
- A3
- A4
- B1
- B3
- B4
- B5
- MED
- D1N
- D1S
- CEN
- D2E
- D2W
- KITCHEN
- LOUNGE
- OTHER
- HALL CLOSET
COMMON AREAS
Common Area (109 / Horseshoe/114/111/Pipechase)
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Everything is clean and within compliance
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Chemicals are inventoried and property labeled
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General inventory is complete and accurate
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No maintenance issues exist in this area
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No safety issues exist (blocked fire exits, trip hazards, wet floor, etc.)
Tower
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Everything is clean and within compliance
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Chemicals are inventoried and property labeled
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General inventory is complete and accurate
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No maintenance issues exist in this area
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No safety issues exist (blocked fire exits, trip hazards, wet floor, etc.)
DORM 1
COMMON AREA
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Everything is clean and within compliance
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No maintenance issues exist in this area
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No safety issues exist (blocked fire exits, trip hazards, wet floor, etc.)
A
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Everything is clean and within compliance
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No maintenance issues exist in this area
B
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Everything is clean and within compliance
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No maintenance issues exist in this area
C
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Everything is clean and within compliance
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No maintenance issues exist in this area
D
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Everything is clean and within compliance
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No maintenance issues exist in this area
E
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Everything is clean and within compliance
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No maintenance issues exist in this area
F
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Everything is clean and within compliance
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No maintenance issues exist in this area
G
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Everything is clean and within compliance
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No maintenance issues exist in this area
H
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Everything is clean and within compliance
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No maintenance issues exist in this area
I
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Everything is clean and within compliance
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No maintenance issues exist in this area
J
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Everything is clean and within compliance
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No maintenance issues exist in this area
K
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Everything is clean and within compliance
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No maintenance issues exist in this area
L
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Everything is clean and within compliance
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No maintenance issues exist in this area
M
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Everything is clean and within compliance
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No maintenance issues exist in this area
N
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Everything is clean and within compliance
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No maintenance issues exist in this area
O
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Everything is clean and within compliance
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No maintenance issues exist in this area
DORM 2
COMMON AREA
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Everything is clean and within compliance
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No maintenance issues exist in this area
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No safety issues exist (blocked fire exits, trip hazards, wet floor, etc.)
A
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Everything is clean and within compliance
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No maintenance issues exist in this area
B
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Everything is clean and within compliance
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No maintenance issues exist in this area
C
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Everything is clean and within compliance
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No maintenance issues exist in this area
D
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Everything is clean and within compliance
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No maintenance issues exist in this area
E
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Everything is clean and within compliance
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No maintenance issues exist in this area
F
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Everything is clean and within compliance
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No maintenance issues exist in this area
G
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Everything is clean and within compliance
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No maintenance issues exist in this area
H
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Everything is clean and within compliance
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No maintenance issues exist in this area
I
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Everything is clean and within compliance
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No maintenance issues exist in this area
J
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Everything is clean and within compliance
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No maintenance issues exist in this area
K
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Everything is clean and within compliance
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No maintenance issues exist in this area
L
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Everything is clean and within compliance
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No maintenance issues exist in this area
M
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Everything is clean and within compliance
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No maintenance issues exist in this area
N
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Everything is clean and within compliance
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No maintenance issues exist in this area
O
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Everything is clean and within compliance
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No maintenance issues exist in this area
DORM 3
COMMON AREA
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Everything is clean and within compliance
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No maintenance issues exist in this area
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No safety issues exist (blocked fire exits, trip hazards, wet floor, etc.)
A
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Everything is clean and within compliance
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No maintenance issues exist in this area
B
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Everything is clean and within compliance
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No maintenance issues exist in this area
C
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Everything is clean and within compliance
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No maintenance issues exist in this area
D
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Everything is clean and within compliance
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No maintenance issues exist in this area
E
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Everything is clean and within compliance
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No maintenance issues exist in this area
F
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Everything is clean and within compliance
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No maintenance issues exist in this area
G
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Everything is clean and within compliance
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No maintenance issues exist in this area
H
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Everything is clean and within compliance
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No maintenance issues exist in this area
I
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Everything is clean and within compliance
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No maintenance issues exist in this area
J
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Everything is clean and within compliance
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No maintenance issues exist in this area
K
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Everything is clean and within compliance
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No maintenance issues exist in this area
L
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Everything is clean and within compliance
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No maintenance issues exist in this area
M
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Everything is clean and within compliance
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No maintenance issues exist in this area
N
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Everything is clean and within compliance
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No maintenance issues exist in this area
O
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Everything is clean and within compliance
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No maintenance issues exist in this area
DORM 4
COMMON AREA
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Everything is clean and within compliance
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No maintenance issues exist in this area
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No safety issues exist (blocked fire exits, trip hazards, wet floor, etc.)
A
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Everything is clean and within compliance
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No maintenance issues exist in this area
B
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Everything is clean and within compliance
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No maintenance issues exist in this area
C
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Everything is clean and within compliance
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No maintenance issues exist in this area
D
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Everything is clean and within compliance
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No maintenance issues exist in this area
E
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Everything is clean and within compliance
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No maintenance issues exist in this area
F
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Everything is clean and within compliance
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No maintenance issues exist in this area
G
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Everything is clean and within compliance
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No maintenance issues exist in this area
H
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Everything is clean and within compliance
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No maintenance issues exist in this area
I
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Everything is clean and within compliance
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No maintenance issues exist in this area
J
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Everything is clean and within compliance
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No maintenance issues exist in this area
K
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Everything is clean and within compliance
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No maintenance issues exist in this area
L
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Everything is clean and within compliance
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No maintenance issues exist in this area
M
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Everything is clean and within compliance
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No maintenance issues exist in this area
N
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Everything is clean and within compliance
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No maintenance issues exist in this area
O
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Everything is clean and within compliance
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No maintenance issues exist in this area
Miscellaneous
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Comments