Title Page

  • Site

  • Date and Time of Inspection

  • Officer in Charge (Full Name)

  • Plumber in Charge (Full Name)

  • Location

General Information

  • Description of work

Property Assessment

  • No evidence of standing water

  • No leaks from septic tanks or leech fields

  • No stains on floors, walls or ceilings

  • No significant cracks in walls or ceilings

  • Visible pipes: no damage, no evidence of leaks, no signs of stains on materials near pipes; drain pipes slope slightly down towards outlet to septic/sewage system

  • Water pump: does not short cycle

  • Galvanized pipes do not restrict water flow

Origin and Causes of Leak

  • Location

  • Take a photo (if applicable)

  • Cause of Leak

  • Please specify


  • Repair works

  • Estimated time to finish the job


  • Officer in Charge

  • Plumber in Charge

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