Title Page
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Concealed Space Inspection:
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Document No.
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Client / Site
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Job Number:
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Conducted on
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Prepared by
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Location/Area of Inspection
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Attendees
Structure
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Structure
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Prime Paint Touch-Up
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Bolt/Weld Inspection
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Weld Painted
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Roof Drains Supported
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Bolts Tight
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Opening Steel in Place
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Fireproofing
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Fireproofing
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Gaps Patched
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Overspray Removed
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Coverage Complete
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Deck Bottom
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Deck Bottom
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Clean
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Hangers Correct
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Electric Cells ID
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Communication/Data Cells ID
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Fire stopping
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Fire Stopping
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Top Of Walls
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Pipe Penetrations
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Decking Flutes Filled In
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Conduit Penetrations
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Duct Penetrations
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Exterior Wall
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Floor Expansion/Contraction Joints
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Wall Expansion/Contraction Joints
Piping
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Piping
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Sprinkler
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Sprinkler Heads
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Domestic Water
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Hot Water
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Chilled Water
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Condensate
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Steam
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Valve Tags
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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ID/Flow Labels
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Valve Access
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Valve Chain Operators
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Hangers
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Hangers Saddles & Nuts
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Roof Drains & Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Insulation
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Insulation Termination
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Vibration Isolation
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Clean
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Walls
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Walls
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Finish
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Anchors
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Supports/Bracing
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Seals
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Expansion/Contraction Joints
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Fire Stops
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Duct Work
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Duct Work
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Supports/Hangers
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Insulation (pin/glue)
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Isolation at Unit
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Dampers/Operators
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Access Panels
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Clean (Interor/Exterior)
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Ceiling
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Ceiling
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Grid Supports/Hangers
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Grid Configuration
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Grid Color
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Hard Ceiling Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Light Fixture Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Access Panels
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Grid Clean
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Top of Tile Clean
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Seismic Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Electrical
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Electrical
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Conduit Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Junction Box Covers
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Identification
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Light Fixture Drops
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Exit Signs
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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No Grid Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Com/Data
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Communication/Data
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Conduit
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Cable Support
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Junction Box Covers
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Devices
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Power Drops
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Fire Alarm
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Fire Alarm
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Conduit Supports
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Identification
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Alarm Indicators
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Alarm Boxes
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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Junction Box Covers
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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No Grid Support
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Cleanliness
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Cleanliness
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Comments:
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Cleaned Pre-Closure
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Additional Items
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Additional Items
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Status Codes;
A - Acceptable R - Rejected D - Damaged M - Missing I - Incomplete C - Clean
WORK NOT NOTED "A-ACCEPTABLE" SHOULD BE ADDED TO THE CONTINUED COMPLETION LOG (CCL) -
Comments:(add item here in a numeric list and select response that coincides with that response below)
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1.
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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2.
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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3.
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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4.
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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5.
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
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6.
- Acceptable
- Rejected
- Damaged
- Missing
- Incomplete
- Clean
Acceptance
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Does the work conform to the Contract Documents?
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If not is re-inspection by PAC acceptable?
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Comments:
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Acceptance Signatures:
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