Gov Owned, Privatized, and Leased Inspection Checklist, page 1

General Information

Installation

District

Unit Address

State/Providence

Country

Year Built (YYYY)

Housing Rep Name
Housing Rep Signature
Rep Email

Priv Management Name

Priv Management Signature

Resident Name

Resident Signature
Property & Inspection Type

Property Type

Inspection Type
General Safety

Does every habitable room meet local/building/occupancy ordinance requirements for egress for emergency escape and rescue opening?

Does unit have cordless window coverings or tension/hold-down devises on corded window coverings in accordance with ANSI/WCMA A100.1-2018?

Does the unit have opening controls or limits on all windows above the ground floor in accordance with 10 USC 2879(a)?

Do all exterior doors and windows openclose/lock properly?

Are all Fire Doors and Emergency Exits unlocked and in working order?

Are there properly secured handrails and guard rails on all interior and exterior stairs and stairwells?

Are all government or privatized housing provided free-standing furnishings and equipment properly anchored as required?

Are smoke alarms in working order?

Manufacture Date:

Is the existing smoke detector and fire sprinkler system connected to the Fire Alarm Control Panel and Installation Fire Response System?

Manufacture Date (Smoke Detector):

Is the existing smoke detector and fire sprinkler system connected to the Fire Alarm Control Panel and Installation Fire Response System?

Are Carbon Monoxide Detectors in working order and present on every floor outside of habitable sleeping areas?

Manufacture Date (Carbon Monoxide Detector):

Is the unit free of any identified gas or propane hazards ("rotten eggs" smell, disconnected gas appliances, or gas equipment, etc)?

Are interior GFCI outlets (within six feet of a water source) working?

Are exterior GFCI outlets working?

Are all exterior, garage, and unfinished basement receptacles protected by GFCIs?

Is the unit free of any identified electrical hazards (tripped breakers that won't reset, overloaded outlets, scorch marks on outlets, etc)?

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

Lead Based Paint

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

Was a lead based paint inspection or risk assessment conducted on the unit?

Does the unit have a State issued Lead Free Certification or approved Lead-Based Paint inspection that found no interior or exterior lead-based paint? If yes, go to
next section.

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)

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

Radon

Has there been previous testing for Radon?

If yes, Date:

Reading:

Has the unit been retested since being renovated, resided, or having a window/door or HVAC replacement?

If present, is the Radon Mitigation system in working order?

Date of last system inspection:

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

Gov Owned, Privatized, and Leased Inspection Checklist, page 2

Mold/Moisture Control Measurements and Reading (More than one reading may need to be taken to enable a representative reading for level)
Temperature <55° F

Outdoor Readings

Main Floor Readings

Second Floor Readings

Third Floor/Basement Readings

Crawl Space Readings

Attic Readings

Comments

Dew Point <55° F

Outdoor Readings

Main Floor Readings

Second Floor Readings

Third Floor/Basement Readings

Crawl Space Readings

Attic Readings

Comments

Relative Humidity 30%-50%

Outdoor Readings

Main Floor Readings

Second Floor Readings

Third Floor/Basement Readings

Crawl Space Readings

Attic Readings

Comments

Mold/Moisture Control - Continued

Is the unit free of visible mold,water damages/stains, and persistent dampness/moisture on all surfaces and surface coverings?

Is the unit free of any visible signs of leaks at plumbing fixtures or appliances?

Is the unit free of any strong musty odors?

Does the unit have a drainage system or does the water drain away from the structure?

Is the unit free of any visible standing water against the foundation?

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

Pest Management

Does the unit appear to be free of pests?

Are there pest management methods in place to ensure unit is free of infestation?

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

Asbestos

Does the unit have an asbestos inventory assessment?

Is potential asbestos containing material free of visible damage (walls, ceilings, fibrous pipe, tile flooring, etc.)?

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

Water

Have sink faucets been sampled for lead in drinking water or are they scheduled for sampling?

Does the resident have access to the Consumer Confidence Report for drinking water and is the water supply tested in accordance with Safe Drinking Water Act and state regulations (As applicable/US locations only)?

Have other units in the building/neighborhood been tested for lead in water?

Does the unit have potable water?

Is the tap water free of any visual discoloration or oily consistency?

Is tap water free of any odors?

Does the unit have adequate water pressure?

Is the water temperature less than 120 degrees Fahrenheit?

If the unit has a water filtration system, have the filters been changed according to the manufacturer's guidelines?

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

HVAC

Are all exhaust fans in working order (Kitchen, Bathroom, Laundry, etc.)

Is dryer vent in working order?

Is heating system in working order?

Is air conditioning system in working order?

Is the humidifier/dehumidifier in working order?

Is the unit free of any visible damage to or leaks in ducts (No visisble gaps, tears, or holes in ducts)?

Are HVAC and plumbing components and systems properly insulated (No signs of condensation or rust)?

Has HVAC filter been changed per installation policy?

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

Gov Owned, Privatized, and Leased Inspection Checklist, page 3

Fire Sprinklers

Are the fire sprinkler control valve(s) open?

Are the fire sprinkler heads free of paint or convering?

Are the fire sprinkler effective spray area free of any obstructions (i.e. anything hanging form a sprinkler head)?

Have the fire sprinklers been inspected according to the regulations?

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

G - Good - Like new, fully functional. No potential LHS issues.

F - Fair - Functional, minor or cosmetic damage only. No potential LHS issues.

P - Poor - Not functional. Requires repair.

LHS - Life/Health/Safety - Present potential LHS hazard. Requires repair and/or further inspection.

NA - Not Applicable - Component is not present in room.

Condition Codes

WRN - Component is serviceable but worn and Good near end of life.

CLN - Needs cleaning.

REP - Needs to be replaced.

NR - Needs to be repaired.

NP - Needs paint

MIS - Missing item or part

SCR - Scratched

STN - Stains/ stained

Exterior
Doorbell

Doorbell Rating

Doorbell Condition

Comment

Front/Back Storm Doors

Front/Back Exterior Doors Rating

Front/Back Exterior Doors Condition

Comment

Front/Back Storm Doors Door

Front/Back Storm Doors Door Rating

Front/Back Storm Doors Condition

Comment

Widows/Screens Ground Floor

Windows/Screens Ground Floor Rating

Windows/Screens Ground Floor Condition

Comment

Windows/Screens Above Ground Floor

Windows/Screens Above Ground Floor Rating

Windows/Screens Above Ground Floor Condition

Comment

Stucco

Stucco Rating

Stucco Condition

Comment

Siding

Siding Rating

Siding Condition

Comment

Brick/Masonry

Brick/Masonry Rating

Brick/Masonry Condition

Comment

Roof

Roof Rating

Roof Condition

Comment

Flashing

Flashing Rating

Flashing Condition

Comment

Soffit/Fascia

Soffit/Fascia Rating

Soffit/Fascia Condition

Comment

Vent Pipes

Vent Pipes Rating

Vent Pipes Condition

Comment

Outside Draining (Gutters/Downspouts)

Outside Draining (Gutters/Downspouts) Rating

Outside Draining (Gutters/Downspouts) Condition

Comment

Landscaping

Landscaping Rating

Landscaping Condition

Comment

Visible Foundation

Visible Foundation Rating

Visible Foundation

Comment

Drip Line (Bare Soil)

Drip Line (Bare Soil) Rating

Drip Line (Bare Soil) Condition

Comment

Porch/Patio

Porch/Patio Rating

Porch/Patio Condition

Comment

Balcony/Deck

Balcony/Deck Rating

Balcony/Deck Condition

Comment

Fence/Gate, and Latches

Fence/Gate, and Latches Rating

Fence/Gate, and Latches Condition

Comment

Carport/Garage/Driveway

Carport/Garage/Driveway Rating

Carport/Garage/Driveway Condition

Comment

Exterior Lighting (operational)
Exterior Lighting (operational) Rating
Exterior Lighting (operational) Condition

Comment

Electrical Outlet(s) GFCI Protected

Electrical Outlet(s) GFCI Protected Rating

Electrical Outlet(s) GFCI Protected Condition

Comment

Exterior Hose Bib

Exterior Hose Bib Rating

Exterior Hose Bib Condition

Comment

Stars/Stairwells
Stars/Stairwells Rating
Stars/Stairwells Condition

Comment

HVAC

HVAC Rating

HVAC Condition

Comment

Water Heater

Water Heater Rating

Water Heater Condition

Comment

Gov Owned, Privatized, and Leased Inspection Checklist, page 4

Kitchen
Kitchen Doors

Kitchen Doors Rating

Kitchen Doors Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Flooring

Flooring Rating

Flooring Condition

Comment

Walls

Walls Rating

Walls Condition

Select RoomType

Comment

Windows/Blinds/Sills/Sashes

Windows/Blinds/Sills/Sashes Rating

Windows/Blinds/Sills/Sashes Condition

Rating Condition

Comment

Pantry Door/Shelving

Pantry Door/Shelving Rating

Pantry Door/Shelving Condition

Comment

Cabinet Doors/Drawers/Shelves

Cabinet Doors/Drawers/Shelves Rating

Cabinet Doors/Drawers/Shelves Condition

Comment

Counter Tops and Sink(s)

Counter Tops and Sink(s) Rating

Counter Tops and Sink(s) Condition

Comment

Caulk

Caulk Rating

Caulk Condition

Comment

Microwave

Microwave Rating

Microwave Condition

Comment

Sinks and Faucets (hot/cold)

Sinks and Faucets (hot/cold) Rating

Sinks and Faucets (hot/cold) Condition

Comment

Dishwasher (operational)

Dishwasher (operational) Rating

Dishwasher (operational) Condition

Comment

Garbage Disposal (operational)

Garbage Disposal (operational) Rating

Garbage Disposal (operational) Condition

Comment

Refrigerator

Refrigerator Rating

Refrigerator Condition

Comment

Range/Oven

Range/Oven Rating

Range/Oven Condition

Comment

Appliance Light Bulbs (operational)

Appliance Light Bulbs (operational) Rating

Appliance Light Bulbs (operational) Condition

Comment

Ventilation (Range)

Ventilation (Range) Rating

Ventilation (Range)

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

Living Room
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Dining Room
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Den
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Laundry Room
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Exhaust Fans

Exhaust Fans Rating

Exhaust Fans Condition

Comment

HVAC System(s)

HVAC System(s) Rating

HVAC System(s) Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Washing Machine Supply and Drain

Washing Machine Supply and Drain Rating

Washing Machine Supply and Drain Condition

Comment

Clothes Dryer Vent Pipe

Clothes Dryer Vent Pipe Rating

Clothes Dryer Vent Pipe Condition

Comment

Mechanical Room
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Exhaust Fans

Exhaust Fans Rating

Exhaust Fans Condition

Comment

HVAC System(s)

HVAC System(s) Rating

HVAC System(s) Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Washing Machine Supply and Drain

Washing Machine Supply and Drain Rating

Washing Machine Supply and Drain Condition

Comment

Clothes Dryer Vent Pipe

Clothes Dryer Vent Pipe Rating

Clothes Dryer Vent Pipe Condition

Comment

Basement
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Exhaust Fans

Exhaust Fans Rating

Exhaust Fans Condition

Comment

HVAC System(s)

HVAC System(s) Rating

HVAC System(s) Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Washing Machine Supply and Drain

Washing Machine Supply and Drain Rating

Washing Machine Supply and Drain Condition

Comment

Clothes Dryer Vent Pipe

Clothes Dryer Vent Pipe Rating

Clothes Dryer Vent Pipe Condition

Comment

Sunroom
Interior Doors

Interior Doors Rating

Interior Doors Condition

Comment

Stairs

Stairs Rating

Stairs Condition

Comment

Handrails

Handrails Rating

Handrails Condition

Comment

Ceiling

Ceiling Rating

Ceiling Condition

Comment

Vinyl Flooring

Vinyl Flooring Rating

Vinyl Flooring Condition

Comment

Tile Flooring

TileFlooring Rating

Tile Flooring Condition

Comment

Carpet Flooring

Carpet Flooring Rating

Carpet Flooring Condition

Comment

Wood/Laminate Flooring

Wood/Laminate Flooring Rating

Wood/Laminate Flooring Condition

Comment

Walls and Trim

Walls and Trim Rating

Walls and Trim Condition

Comment

Window/Sills/Sashes

Window/Sills/Sashes Rating

Window/Sills/Sashes Condition

Rating Condition

Comment

Window Blinds/Shutters/Shades

Window Blinds/Shutters/Shades Rating

Window Blinds/Shutters/Shades Condition

Comment

Lighting (Fixtures and Bulbs)

Lighting (Fixtures and Bulbs) Rating

Lighting (Fixtures and Bulbs) Condition

Comment

GFCI Protected Electrical Outlet(s)

GFCI Protected Electrical Outlet(s) Rating

GFCI Protected Electrical Outlet(s) Condition

Comment

Fireplace

Fireplace Rating

Fireplace Condition

Comment

Fire Extinguisher

Fire Extinguisher Rating

Fire Extinguisher Condition

Comment

Ceiling Fans

Ceiling Fans Rating

Ceiling Fans Condition

Comment

Exhaust Fans

Exhaust Fans Rating

Exhaust Fans Condition

Comment

HVAC System(s)

HVAC System(s) Rating

HVAC System(s) Condition

Comment

Smoke Detectors

Smoke Detectors Rating

Smoke Detectors Condition

Comment

Carbon Monoxide Detectors

Carbon Monoxide Detectors Rating

Carbon Monoxide Detectors Condition

Comment

Washing Machine Supply and Drain

Washing Machine Supply and Drain Rating

Washing Machine Supply and Drain Condition

Comment

Clothes Dryer Vent Pipe

Clothes Dryer Vent Pipe Rating

Clothes Dryer Vent Pipe Condition

Comment

Gov Owned, Privatized, and Leased Inspection Checklist, page 5

Bedroom Location Description

Bedroom 1 Location Description

Bedroom 2 Location Description

Bedroom 3 Location Description

Bedroom 4 Location Description

Bedroom 5 Location Description

Bathroom Location Description

Bathroom 1 Location Description

Bathroom 2 Location Description

Bathroom 3 Location Description

Bathroom 4 Location Description

Bathroom 5 Location Description

Gov Owned, Privatized, and Leased Inspection Checklist, page 6

Follow-Up Actions
Follow-up Actions
Overall Unit Inspection Results
Overall Unit Inspection Results

Installation/Garrison Commander Waiver

Installation/Garrison Commander Waiver

Installation/Garrison Commander Signature
Inspection Comments

Inspection Comments

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.