Leak Inspection Checklist

• Site

• Date and Time of Inspection

  Date

• Officer in Charge (Full Name)

• Plumber in Charge (Full Name)

• Location
  Address

General Information

• Description of work

Property Assessment

• No evidence of standing water

  ✔

  ✖

  N/A

• No leaks from septic tanks or leech fields

  ✔

  ✖

  N/A

• No stains on floors, walls or ceilings

  ✔

  ✖

  N/A

• No significant cracks in walls or ceilings

  ✔

  ✖

  N/A

• 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

  ✔

  ✖

  N/A

• Water pump: does not short cycle

  ✔

  ✖

  N/A

• Galvanized pipes do not restrict water flow

  ✔

  ✖

  N/A

Origin and Causes of Leak

• Location

• Take a photo (if applicable)

  Media

• Cause of Leak

  Broken seals

  Clogged lines

  Corrosion

  Damaged pipe joints

  Other

• Please specify

Recommendation

• Repair works

• Estimated time to finish the job

  Date

Sign-off

• Officer in Charge

  Sign

• Plumber in Charge

  Sign