• Conducted on

  • Inspection No.

  • Inspector

  • Audit Title

  • Lease Contract Number

  • Lease Account Manager (LAM) or COTR Name / Telephone

  • Lease Contracting Officer Name / Telephone

  • Building Number

  • Rentable Square Feet

Lease Location and Information

  • Building Name

  • Building Address
  • Number of Employees

  • Lease Expiration Date

  • HSPD-12


  • Energy Star requirements met?

  • LEED Certified?

  • Computer or Server Room present?

  • Date of last Tentant Satisfaction Survey (TSS)

  • TSS Score

  • TSS Response Rate

Cyclical Maintenance


  • Carpet replacement last completed

  • Carpet replacement next due


  • Cyclic painting last completed

  • Cyclic painting next due

Lessor and Customer Agency Information


  • Lessor Name

  • Lessor Telephone


  • Agency Representative Name

  • Agency Representative Telephone

  • Agency Representative Email

Management Company

  • Mgmt Company Name

  • Mgmt Company Address
  • Mgmt Company Email

  • After Hours Telephone

Non-Fully Serviced Leases

  • Is this a fully-serviced lease?

  • Are additional services provided?

  • Additional Services

  • Utility
  • Which utilities are provided?

Fire Life & Safety

  • Date of last Safety Inspection

  • Date of last Fire Drill

  • Have fire extinguishers been serviced?

  • Date fire extinguishers were last serviced

A. Periodic Services

  • For section A. Periodic Services, please enter a comment identifying the frequency for each requirement.

  • A. Mop & spray buff resilient floor

  • B. Damp wipe toilet partitions, etc.

  • C. Entrance mats

  • D. High cleaning

  • E. Strip and wax floors

  • F. Shampoo corridor and lobby carpets

  • G. Shampoo other office carpets

  • H. Drapery cleaning

  • I. Venetian Blind cleaning

  • J. Wall covering replacement

  • K. Window washing

B. First Impressions: Grounds/Parking/Lobby

Building Exterior

  • Walls are in good repair (not chipped, cracked, or damaged; paint in good condition).

  • Entry doors are clean and in good repair.

  • Handicap door is available and functional.

  • Waste bins / cigarette receptacles are accessible and clean.

  • Overall appearance is not run down.

  • Exterior appears to be in good condition.

  • Roofing appears to be in place with no missing shingles or tiles.


  • Parking lot, sidewalks, steps, ramps, driveways and loading dock areas are free of debris.

  • Parking spaces are clearly marked with bumpers/curbs in place.

  • Directional signs are adequate.

  • Landscaping is well maintained.

  • Lighting / lens are intact and not burning during daylight hours.


  • Waste bins are available and clean.

  • Interior signage is adequate.

  • Main lobby and public areas are clean and litter free.

C. Breakrooms and Kitchenette

  • Sink is in good condition (hot and cold water work; faucets not dripping or worn; sink not stained, chipped, dented, or worn).

  • Backsplash is clean and without spots.

  • Paper and soap dispensers are working and stocked.

  • Waste bins are clean.

D. Finishes and Stairwells


  • Ceiling tiles not stained, cracked, broken or<br>missing.

  • Light fixtures working; lenses not cracked, broken or missing. Bulbs/tubes in place.


  • Carpet in good condition without rips, tears, stains, or badly worn areas.

  • Floor tile in good condition without loose, cracked, or missing tiles.

  • Cove base is securely fastened to the wall; no missing sections; colors matching.


  • Paint is not peeling, flaking, or mismatched; not too badly soiled for cleaning.

  • Electrical outlets appear to be in working order (spot checked).

  • Wall covering is not torn, stained, or peeling from the surface. Repairs match.

  • Walls in good condition; no holes or sloppy patching.


  • Window blinds are clean and in good shape, i.e. blinds are not bent; tapes and cords are not damaged, drapes in good shape without holes, tears, or missing sections.

  • Window coverings are in good condition, without tears, sagging hems, or missing hooks or panels.

  • Windows and window seals are without cracks, holes, or drafts.


  • Doors in good condition; clean, open, close, and latch properly without scraping the doorframe; not warped.

  • Locksets are intact and easily operable.


  • No egress obstructions, well maintained, illuminated, emergency lighting, directional signage in place, and clean.

E. Restrooms / Locker Rooms


  • Sinks are clean and in good condition.

  • Faucets provide hot and cold water, are securely fastened, and are not leaking.

  • Exposed pipe under ADA sink is properly wrapped.


  • Toilets are in good condition, can be flushed, and are not leaking or running.

  • Partitions and stalls are in clean and in good condition.

  • Toilet seat and bowl are securely fastened to its fixture (wall or floor) and are not broken.

  • Toilet paper holder is properly secured, is without damage, and is stocked.


  • Shower stalls are in good working order and cleaned regularly.

  • Floor drains are clean and without odors.


  • Adequate supplies, i.e. soap, paper towels, toilet seat covers, and sanitary napkins all with working dispensers in good condition.

F. Offices and Corridors

  • Waste bins are not overflowing and appear to be emptied daily.

  • Main traffic areas (floors) are clean and show only one day's accumulation of dirt, dust, and debris.

  • Carpet not spotted or having appearance of not being cleaned for more than one week.

  • Horizontal furniture surfaces and chair rails are dust free or appear to have been cleaned within the last week.

  • Drinking fountains have no soil or lime deposits. Fountains show no visible signs of damage and the water pressure is adequate.

G. Elevators

  • Elevators are well maintained, illuminated, clean, leveling properly, and emergency phones are operational.

  • Emergency elevator telephone tested to reach operator.

  • Elevator inspection certificate is posted and current.

H. Safety and Environmental

  • Tenant agency is not engaged in unsafe work practices, i.e. permanent use of extension cords, improper storage of chemical, and is not blocking exits, isles, or stairways.

  • Has any spill or release of hazardous materials occurred?

  • Is any disposal of hazardous waste planned?

  • Lessor is not engaged in unsafe work practices, i.e. permanent use of extension cords, improper storage of chemical, and is not blocking exits, isles, or stairways.

  • Sprinkler heads are intact, clean, and unobstructed.

  • Deficient items from last Safety and Environmental survey have been corrected.

  • Fire extinguishers in common areas are wall mounted, and inspection tags are current.

  • Battery pack emergency lighting appears effective (spot checks).

  • Exit signs are illuminated for egress.

  • Integrated Pest Management Plan is in place.

I. Utility / Energy

  • The HVAC system fans are quiet and operating properly. Temperatures are consistent throughout space; no areas noticeably warmer or colder areas.

  • The temperature settings/actual temperatures are within lease requirements.

  • The HVAC system operates during the agency's official working hours.

  • Meter readings were taken for GSA contracted utilities only. Readings are above or below readings on the most recent invoices.

J. Preventive Maintenance

  • Preventive maintenance for above standard lease equipment is being performed in accordance with manufacturer's recommendations.

K. Sustainability

  • Recycling program is operating effectively, with containers & service in place. Tenants are aware and informed of the program

  • The lessor has provided recycling records.

  • Is facility meeting GSA's goal to divert at least 30% of waste from landfills?

  • The lessor's service providers, notably for janitorial and landscaping work, are using Comprehensive Procurement Guideline (CPG) items, environmentally preferable products, equipment, and practices.

  • Lessor has responded to the environmental products and recycling letter.

  • Are energy efficient upgrades or Energy Star certifications required by the lease?

  • Lessor has made energy efficient upgrades or achieved Energy Star certification and provided documentation within the required time frame.

  • Is LEED certification required by the lease?

  • Lessor has obtained LEED certification and provided documentation within the required time frame.

Summary Comments

  • Summary comments and remarks.

  • Inspector

  • GSA Property Manager

  • Lessor Representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.