Information

  • Building / Client site

  • Conducted on

  • Prepared by

  • Location

Lighting

  • All lights/bulbs/lamps checked and none needs replacement?

  • Exterior lights and cables aren’t torn; all screws and hardware in place and working?

  • All exit lighting are properly installed and functioning?

  • All interior lighting are properly installed and functioning?

  • All exterior lighting are properly installed and functioning?

Electrical

  • Have you changed batteries in smoke and carbon monoxide detectors, flashlights and test instruments?

  • Timers and photocells are functioning correctly?

  • Cover plates have no cracks and have proper tightness?

  • All exhaust fans are clean?

Safety

  • Checked inventory and restocked all first aid kits?

  • Checked eyewash bottles and stations?

  • Safety signs and equipment labels are in good condition?

HVAC

  • Air intake cleaned (as needed)?

  • Changed all air filters (as needed)?

  • Blower motors in operation have no excessive noise or vibration?

  • Cleaned motors and ductwork (as needed)?

  • Condensate drain pan has proper drainage?

  • Checked the flexible duct connectors?

  • Guards and panels are secured and not loose?

  • All electrical hardware and connections are in good condition?

  • Controls and equipment tested and safe?

  • Interior unit operating properly?

  • Condenser motor bearings have no excessive noise or vibration?

  • Inspected the condenser air intake, discharge, and coil?

  • All refrigerant piping and insulation in good condition?

  • Guards or access panels secured and not loose?

  • Exterior unit in good operation?

  • Inspected compressed air lines regularly? No leaks in piping, tubing or fittings?

  • Replaced or cleaned air filter elements at least quarterly, or as necessary depending on the application?

  • Oil levels on air compressor pumps monitored and replaced (as necessary depending on usage)?

Building Interior

  • Floors, ceilings, and walls show no evidence of deterioration?

  • No visible signs of leaks?

  • Inspected and found no hazards (electrical, mechanical, structural, physical, tripping, etc.)?

  • Faucets, toilets, and showers are operational and in good working condition?

  • Smoke and carbon monoxide detectors tested and working?

  • Fire alarm system tested and working?

  • Firefighting equipment in good condition?

  • All doors in proper operation; exits are not obstructed?

  • Door locks and closures in good condition?

  • Work areas and walkways are properly marked?

  • No accumulation of trash in storage areas?

  • No evidence of insect infestation?

  • Cart casters show no wear and that shelving is properly labeled, organized, and secured?

Building Exterior

  • Paint and walls in good condition?

  • No broken windows or doors?

  • All railings in good condition?

  • Cleaned roof drains and gutters (as needed)? Tested drains and downspouts by flushing them with water?

  • Roof in good condition?

  • Gutters have adequate anchoring and tightened if necessary?

  • Inspected the stack and all roof penetrations?

  • No debris found? (clean if any)

  • No broken glass and debris on the grounds?

  • Sidewalk in good condition?

  • Driveway and parking area in good condition?

  • Storm water drains in good condition?

  • Plants and lawns in good condition?

  • Trees in good condition; no branches are about to fall?

  • Area around the dumpsters are clean?

  • Fencing in good condition?

Plumbing

  • Plumbing inspected at least annually? No leaks or unusual noises?

  • Domestic water booster and circulation pump systems require bearing lubrication at least annually; no leaks on couplings?

  • Are domestic water heaters and boilers fire-tested periodically? Used flue-gas analysis to adjust the flue draft and combustion air input to help optimize efficiency?

  • Remote drinking water chillers need condenser fan motor bearings lubricated annually. All contacts show no wear and pitting? Ran system control tests?

  • Pumped down the system and removed the refrigerant according to manufacturer instructions? Drained and replaced oil in the compressor oil reservoir, including filters, strainers and traps?

  • Sump and sewage ejection pumps are functioning properly (and replaced on an as-needed basis)? Exposed pumps lubricated (annually)?

Completion

  • Name and signature:

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