Information
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Document No.:
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Project Name:
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Jobsite Address:
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Date/Time:
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Job#:
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Prepared by:
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General Contractor:
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Personnel (Name & Title):
Deficiency Items
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Deficiency No. 001:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 002:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 003:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 004:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 005:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 006:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 007:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 008:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 009:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 010:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 011:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 012:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 013:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 014:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 015:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 016:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 017:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 018:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 019:
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Company/Trade Responsible:
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Photos:
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Deficiency No. 020:
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Company/Trade Responsible:
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Photos:
Additional Information
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Notes, Issues, Concerns:
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Photos:
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Site Safety Observations:
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Photos:
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Quality Control Observations:
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Photos:
Signature
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By signing you acknowledge that you have reviewed and completed this report:
