RVCare2U - Essential Plus(#) RV Inspection Report

• Date of Inspection

  Date

• Was this report requested by the current Owner

  Yes

  No

  N/A

• Owners Name

• Owners Address

• City

• State/Province

• Zip Code

• Customers Name

• Customers Address

• City

• State/Province

• Zip Code

• Current Owners Name

• Owners Address

• City

• State/Province

• Zip Code

• Same as the Billing Address?

• Billing Address

• City

• State/Province

• Zip Code

• Email

• Where to send the report?

  Select Main Address Billing Address Email

  • Main Address
  • Billing Address
  • Email

• Year of Manufacturing

• Manufacturer

• Make

• Model

• Vin#

• Location The Inspection was Conducted
  Address

Exterior Photos of Unit

• Front

  Media

• Curbside (Passenger Side)

  Media

• Rear

  Media

• Roadside (Drivers Side)

  Media

• Under The Unit (Video)

  Media

• Roof Top

  Media

Roof Exterior

• Roof Material Condition

  Good

  Fair

  Poor

  N/A

• Front cap joints and seals

  Good

  Fair

  Poor

  N/A

• Awning rail trim (Curbside)

  Good

  Fair

  Poor

  N/A

• Rear cap joints and seals

  Good

  Fair

  Poor

  N/A

• Trim rail (Streetside)

  Good

  Fair

  Poor

  N/A

• Vents - Manual crank

  Good

  Fair

  Poor

  N/A

• Vents - Powered

  Good

  Fair

  Poor

  N/A

• Exterior vent covers

  Good

  Fair

  Poor

  N/A

• Plumbing vent covers

  Good

  Fair

  Poor

  N/A

• Roof Refrigerator vent

  Good

  Fair

  Poor

  N/A

• Skylights

  Good

  Fair

  Poor

  N/A

• Air conditioner #1 - Shroud

  Good

  Fair

  Poor

  N/A

• Air conditioner #1 - Exterior coils

  Good

  Fair

  Poor

  N/A

• Is there multiple rooftop AC units?

  Yes

  No

  N/A

• Air conditioner #2 - Shroud

  Good

  Fair

  Poor

  N/A

• Air conditioner #2 - Exterior coils

  Good

  Fair

  Poor

  N/A

• Air conditioner #3 - Shroud

  Good

  Fair

  Poor

  N/A

• Air conditioner #3 - Exterior coils

  Good

  Fair

  Poor

  N/A

• Air conditioner #4 - Shroud

  Good

  Fair

  Poor

  N/A

• Air conditioner #4 - Exterior coils

  Good

  Fair

  Poor

  N/A

• TV Antenna Exterior Roof Unit

  Good

  Fair

  Poor

  N/A

• Satellite Antenna

  Good

  Fair

  Poor

  N/A

• Radio Antenna

  Good

  Fair

  Poor

  N/A

• Solar Panels

  Good

  Fair

  Poor

  N/A

• Roof Access Ladder

  Good

  Fair

  Poor

  N/A

Material and Style of Roof

• Is roof Walkable

  Yes

  No

  N/A

• Accessible roof method

  Mounted Ladder

  Removable Ladder

  No Ladder

• Roof type

  Select Fiberglass Metal Rubber(EPDM) Rubber(TPO) Vinyl Other

  • Fiberglass
  • Metal
  • Rubber(EPDM)
  • Rubber(TPO)
  • Vinyl
  • Other

• Any signs of prior equipment being removed

  Yes

  No

  N/A

Front cap wall

• Front wall condition

  Good

  Fair

  Poor

  N/A

• Wall finish type

  Decals

  Full body paint

  Paint with decals

  Gel-coat with decals

  Other

• Paint and decals

  Good

  Fair

  Poor

  N/A

• Windows

  Good

  Fair

  Poor

  N/A

• Window style

  Glass with frame

  Glass with no frame

• Window seals

  Good

  Fair

  Poor

  N/A

• Cargo doors

  Good

  Fair

  Poor

  N/A

• Cargo door seals

  Good

  Fair

  Poor

  N/A

• Cargo door style

  Select with keyed lock with slam latch with twist latch

  • with keyed lock
  • with slam latch
  • with twist latch

Curbside Wall

• Side wall condition

  Good

  Fair

  Poor

  N/A

• Wall finish type

  Decals

  Full body paint

  Paint with decals

  Gel-coat with decals

  Other

• Paint and decals

  Good

  Fair

  Poor

  N/A

• Condition of the Wheel skirts

  Good

  Fair

  Poor

  N/A

• Yes

  No

  N/A

• Yes

  No

  N/A

Streetside Wall

• Side wall condition

  Good

  Fair

  Poor

  N/A

• Wall finish type

  Decals

  Full body paint

  Paint with decals

  Gel-coat with decals

  Other

• Paint and decals

  Good

  Fair

  Poor

  N/A

• Door condition

  Good

  Fair

  Poor

  N/A

• Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Windows

  Good

  Fair

  Poor

  N/A

• Window style

  Glass with frame

  Glass with no frame

• Window seals

  Good

  Fair

  Poor

  N/A

• Cargo doors

  Good

  Fair

  Poor

  N/A

• Cargo door seals

  Good

  Fair

  Poor

  N/A

• Cargo door style

  Select with keyed lock with slam latch with twist latch

  • with keyed lock
  • with slam latch
  • with twist latch

Rear Cap Wall

• Rear wall condition

  Good

  Fair

  Poor

  N/A

• Wall finish type

  Decals

  Full body paint

  Paint with decals

  Gel-coat with decals

  Other

• Paint and decals

  Good

  Fair

  Poor

  N/A

• Windows

  Good

  Fair

  Poor

  N/A

• Window style

  Glass with frame

  Glass with no frame

• Window seals

  Good

  Fair

  Poor

  N/A

• Cargo doors

  Good

  Fair

  Poor

  N/A

• Cargo door seals

  Good

  Fair

  Poor

  N/A

• Cargo door style

  Select with keyed lock with slam latch with twist latch

  • with keyed lock
  • with slam latch
  • with twist latch

Door or Ramp

• Door/Ramp condition

  Good

  Fair

  Poor

  N/A

• Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Type of step system

  Electric

  Manual

  Fixed in placed

  N/A

• Condition of Step system

  Good

  Fair

  Poor

  N/A

• Number of steps

• Grab bar type

  D-Ring

  Fixed Grab bar

  N/A

• Condition of Grab bar system

  Good

  Fair

  Poor

  N/A

• Is There Additional Doors

  Yes

  No

  N/A

Door #2

• Door #2 - Condition

  Good

  Fair

  Poor

  N/A

• Door #2 - Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Door #2 - Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Door #2 - Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Door #2 - Type of step system

  Electric

  Manual

  Fixed in placed

  N/A

• Door #2 - Condition of the Step system

  Good

  Fair

  Poor

  N/A

• Door #2 - Number of steps

• Door #2 - Grab bar type

  D-Ring

  Fixed Grab bar

  N/A

• Door #2 - Condition of Grab bar system

  Good

  Fair

  Poor

  N/A

• Are There Additional Doors

  Yes

  No

  N/A

Other door

• Other Door - Location of This Door

• Door condition

  Good

  Fair

  Poor

  N/A

• Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Type of step syystem

  Electric

  Manual

  Fixed in placed

  N/A

• Condition of Step system

  Good

  Fair

  Poor

  N/A

• Number of steps

• Grab bar type

  D-Ring

  Fixed Grab bar

  N/A

• Condition of Grab bar system

  Good

  Fair

  Poor

  N/A

Curbside Wall

• Curbside wall condition

  Good

  Fair

  Poor

  N/A

• Wall finish type

  Decals

  Full body paint

  Paint with decals

  Gel-coat with decals

  Other

• Paint and decals

  Good

  Fair

  Poor

  N/A

• Windows

  Good

  Fair

  Poor

  N/A

• Window style

  Glass with frame

  Glass with no frame

• Window seals

  Good

  Fair

  Poor

  N/A

• Cargo doors

  Good

  Fair

  Poor

  N/A

• Cargo door seals

  Good

  Fair

  Poor

  N/A

• Cargo door style

  Select with keyed lock with slam latch with twist latch

  • with keyed lock
  • with slam latch
  • with twist latch

Door #1 (Rear door)

• Door condition

  Good

  Fair

  Poor

  N/A

• Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Type of step system

  Electric

  Manual

  Fixed in placed

  N/A

• Condition of Step system

  Good

  Fair

  Poor

  N/A

• Number of steps

• Grab bar type

  D-Ring

  Fixed Grab bar

  N/A

• Condition of Grab bar system

  Good

  Fair

  Poor

  N/A

• Is There Additional Doors

  Yes

  No

  N/A

Door #2 (Front door)

• Door #2 - Condition

  Good

  Fair

  Poor

  N/A

• Door #2 - Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Door #2 - Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Door #2 - Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Door #2 - Type of step system

  Electric

  Manual

  Fixed in placed

  N/A

• Door #2 - Condition of the Step system

  Good

  Fair

  Poor

  N/A

• Door #2 - Number of steps

• Door #2 - Grab bar type

  D-Ring

  Fixed Grab bar

  N/A

• Door #2 - Condition of Grab bar system

  Good

  Fair

  Poor

  N/A

• Are There Additional Doors

  Yes

  No

  N/A

Other door

• Other Door - Location of This Door

• Door condition

  Good

  Fair

  Poor

  N/A

• Styles and material

  Fiberglass

  Molded Fiberglass

  Metal Sheet

  Riveted Metal

  Other

• Latch and/or key style

  Keyed Entrance

  Keyless Entrance

  No locking method

• Condition of locking/latching system

  Good

  Fair

  Poor

  N/A

• Type of step syystem

  Electric

  Manual

  Fixed in placed

  N/A

• Condition of Step system

  Good

  Fair

  Poor

  N/A

• Number of steps

• Grab bar type

  D-Ring

  Fixed Grab bar

  N/A

• Condition of Grab bar system

  Good

  Fair

  Poor

  N/A

Front Awning

• Is There a Front Awning

  Yes

  No

  N/A

• Frame and latching mechanism

  Good

  Fair

  Poor

  N/A

• Fabric Condition

  Good

  Fair

  Poor

  N/A

• Awning operation

  Good

  Fair

  Poor

  N/A

Rear Awning

• Is There a Rear Awning

  Yes

  No

  N/A

• Frame and latching mechanism

  Good

  Fair

  Poor

  N/A

• Fabric Condition

  Good

  Fair

  Poor

  N/A

• Awning operation

  Good

  Fair

  Poor

  N/A

Door Awning

• Is There a Door Awning (Generally Motorhomes)

  Yes

  No

  N/A

• Frame and latching mechanism

  Good

  Fair

  Poor

  N/A

• Fabric Condition

  Good

  Fair

  Poor

  N/A

• Awning operation

  Good

  Fair

  Poor

  N/A

Front (Main) Curbside Awning

• Is there a Front (Main) Curb Awning

  Yes

  No

  N/A

• Frame and latching mechanism

  Good

  Fair

  Poor

  N/A

• Fabric Condition

  Good

  Fair

  Poor

  N/A

• Awning operation

  Good

  Fair

  Poor

  N/A

• Is there a Rear Curbside Awning

  Yes

  No

  N/A

• Frame and latching mechanism

  Good

  Fair

  Poor

  N/A

• Fabric Condition

  Good

  Fair

  Poor

  N/A

• Awning operation

  Good

  Fair

  Poor

  N/A

Curbside Front or Only Slideout

• Is There a Curbside Front or (The Only) Slideout

  Yes

  No

  N/A

• Slideout Roof

  Good

  Fair

  Poor

  N/A

• Slideout T- Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Are there Slideout Toppers

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

• Is There A Curbside Center Slide

  Yes

  No

  N/A

Curbside Center Slideout

• What is the Condition of the Curbside Center Slideout

  Good

  Fair

  Poor

  N/A

• Curbside Center Roof

  Good

  Fair

  Poor

  N/A

• Curbside Center T - Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Are there Slideout Toppers

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

• Is There a Rear Side Slideout

  Yes

  No

  N/A

Curbside Rear Slideout

• Condition of the Curbside Rear Slideout

  Good

  Fair

  Poor

  N/A

• Curbside Rear Roof

  Good

  Fair

  Poor

  N/A

• Curbside Rear T - Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Are there Slideout Toppers

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

• Is There a Rear Wall Cap Slideout

  Yes

  No

  N/A

• Rear Wall Slideout

  Good

  Fair

  Poor

  N/A

• Rear Wall Slideout Roof

  Good

  Fair

  Poor

  N/A

• Rear Wall T - Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Are there Slideout Toppers

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

Streetside Rear Slideout

• Is there a Streetside Slideout?

  Yes

  No

  N/A

• Streetside Roof

  Good

  Fair

  Poor

  N/A

• Streetside - Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Is there a Slideout Topper

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

• Is There a Streetside Center Slideout

  Yes

  No

  N/A

Streetside Center Slideout

• Streetside Center Roof

  Good

  Fair

  Poor

  N/A

• Streetside Center T - Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Are there Slideout Toppers

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

• Is There a Streetside Front Slideout

  Yes

  No

  N/A

Streetside Front Slideout

• Streetside Front Roof

  Good

  Fair

  Poor

  N/A

• Streetside Front T - Molding Trim

  Good

  Fair

  Poor

  N/A

• Seals, Sweeps and Gaskets

  Good

  Fair

  Poor

  N/A

• Slide Rail Gear Rack System

  Good

  Fair

  Poor

  N/A

• Wiring Harness under Slideout

  Good

  Fair

  Poor

  N/A

• 12 volt DC Control and Switches

  Good

  Fair

  Poor

  N/A

• Slideout Drive System(s)

  Select Cable w/Electric Motor Electric Motor with Screw Drive Electric Motor w/Gear and Rack System Schwintek w/Electric Motor Hydraulic Piston Hydraulic Motor w/Gear and Rack System

  • Cable w/Electric Motor
  • Electric Motor with Screw Drive
  • Electric Motor w/Gear and Rack System
  • Schwintek w/Electric Motor
  • Hydraulic Piston
  • Hydraulic Motor w/Gear and Rack System

• Slideout Operation

  Good

  Fair

  Poor

  N/A

• Are there Slideout Toppers

  Yes

  No

  N/A

• Slideout Awning topper Frame and Latching Mechanism

  Good

  Fair

  Poor

  N/A

• Slideout Topper Fabric

  Good

  Fair

  Poor

  N/A

Wheel Assembly

• Number of axles on this unit

Front Curbside Wheel

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Amount of Tread Remaining

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

• Is there a Center Curbside Wheel (Triple axle)

  Yes

  No

  N/A

Curbside Center Wheel

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Amount of Tread Remaining

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

• Is There A Rear Curbside Wheel

  Yes

  No

  N/A

Curbside Rear Wheel

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Amount of Tread Remaining

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

Front or Single Streetside Wheel

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Amount of Tread Remaining

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

• Is there a Center Curbside Wheel (Triple axle)

  Yes

  No

  N/A

Center Curbside Wheel

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Amount of Tread Remaining

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

• Is there a Rear Curbside Wheel

  Yes

  No

  N/A

Streetside Rear Wheel

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Amount of Tread Remaining

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

Spare Tire

• Is There A Spare TIre On This Unit

  Yes

  No

  N/A

• Tire Condition

  Good

  Fair

  Poor

  N/A

• Tire Tread Condition

  Good

  Fair

  Poor

  N/A

• Tire Brand

• Tire Size

• Is the DOT Date Available?

  Yes

  No

  N/A

• DOT Date (Week - Year)

• Load Capacity (Lb) (kg)

• Load Range Grade

  Select D E F G H Other

  • D
  • E
  • F
  • G
  • H
  • Other

• Explain (Other)

• Maximum Tire Pressure (psi)

• Current Air Pressure in Tire (psi)

• Spare Tire Rack Type

  Drop Down Rack

  Mounted Rack

  Compartment Storage

  Not Present

• Spare Tire Rack and Tools

  Yes

  No

  N/A

Front or Single Axle

• Axle Type

  Leaf Spring with Shackles

  Torsion Axle

  Other

• Define (Other)

• Was Rust visible on Axle

  Yes

  No

  N/A

• Level of rust visible on axle

  Heavy

  Moderate

  Light

• Was there signs of physical damage to axle

  Yes

  No

  N/A

• Define damage

• Were there signs of oil stains

  Yes

  No

  N/A

• Define Stains

Center Axle

• Is There a Center Axle

  Yes

  No

  N/A

• Axle Type

  Leaf Spring with Shackles

  Torsion Axle

  Other

• Define Other Type

• Was Rust visible on Axle

  Yes

  No

  N/A

• Level of rust visible on axle

  Heavy

  Moderate

  Light

• Was there signs of physical damage to axle

  Yes

  No

  N/A

• Define damage

• Were there signs of oil stains

  Yes

  No

  N/A

• Define Stains

Rear Axle

• Is There a Rear Axle

  Yes

  No

  N/A

• Axle Type

  Leaf Spring with Shackles

  Torsion Axle

  Other

• Define Other Type

• Was Rust visible on Axle

  Yes

  No

  N/A

• Level of rust visible on axle

  Heavy

  Moderate

  Light

• Was there signs of physical damage to axle

  Yes

  No

  N/A

• Define damage

• Were there signs of oil stains

  Yes

  No

  N/A

• Define Stains

Suspension System

• Condition of U-Bolts and Nuts

  Good

  Fair

  Poor

  N/A

• Condition of Leaf Springs

  Good

  Fair

  Poor

  N/A

• Condition of Hangers

  Good

  Fair

  Poor

  N/A

• Condition of Shackles

  Good

  Fair

  Poor

  N/A

• Condition of Spring Equalizer

  Good

  Fair

  Poor

  N/A

• Suspension Bolts

  Good

  Fair

  Poor

  N/A

• Are Wet bolts present

  Yes

  No

  N/A

Condition of Frame

• Was there signs of Physical Damage on the Frame

  Yes

  No

  N/A

• Were there signs of Rust

  Yes

  No

  N/A

• Level of Rust

  Heavy

  Moderate

  Light

Hitch and Stabilizing System

• Is this Unit a 5th Wheel System

  Yes

  No

  N/A

Fifth Wheel Systems

• Type of Landing Gear

  Hydraulic

  Electric

  Manual

• Condition of Front Landing Gear

  Good

  Fair

  Poor

  N/A

• Front Landing Gear Operation

  Good

  Fair

  Poor

  N/A

• Type of Rear Stabilizing System

  Hydraulic

  Electric

  Manual

• Condition of Rear Stabilizing System

  Good

  Fair

  Poor

  N/A

• Rear Stabilizing System Operation

  Good

  Fair

  Poor

  N/A

• Visible leaks or Mechanical Issues with Jacks

  Yes

  No

  N/A

• Type of Pin Box

  Fixed Pin for Swiveling

  King Pin with Air Ride

  King Pin

• Goose Neck Adaptor

  Yes

  No

  N/A

• Is this Unit a Bumper Pull System

  Yes

  No

  N/A

Bumper Pull Systems

• Tongue Jack Type

  Electric

  Manual

  Fixed in placed

  N/A

• Condition of Tongue Jack Operation

  Good

  Fair

  Poor

  N/A

• Coupler Operational

  Good

  Fair

  Poor

  N/A

• Condition of Safety Chains

  Good

  Fair

  Poor

  N/A

• Condition of Stabilizers

  Good

  Fair

  Poor

  N/A

• Condition of Weight Distribution System

  Good

  Fair

  Poor

  N/A

• Condition of Sway Control System

  Good

  Fair

  Poor

  N/A

Chassis 12-volt DC Lights

• What type of 12v DC power connection to Tow Vehicle is available on this unit

  7 Pin

  4 Pin

  No connection

• Condition of the 7-pin Cord (Physical Damage, Corrosion)

  Good

  Fair

  Poor

  N/A

• Condition of the 4 pin 12v DC Connector

  Good

  Fair

  Poor

  N/A

• Physical Condition of the Breakaway Switch

  Good

  Fair

  Poor

  N/A

• Type of Test performed on the Breakaway system

  Select Each axle raised and both wheels confirmed Braking One axle raised and wheel confirmed braking No axles raised, amperage test conducted

  • Each axle raised and both wheels confirmed Braking
  • One axle raised and wheel confirmed braking
  • No axles raised, amperage test conducted

• What was Amperage Reading

• Are All Front Clearance Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Streetside Marker Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Rear Clearance Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Curbside Marker Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are Left Turn and Left Brake Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are Right Turn and Right Brake Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All All Backup Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Rear Flood Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Utility Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Hitching Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Compartment Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Porch Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Are All Security Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Condition of the Waste Dump Lights

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

• Define which lights are not working

• Are All Waste Dump Lights Operational

  Yes

  No

  N/A

• Are Some Operational Or Are all Non-Operational

  Only Partial Lights Working

  No Lights Working

  All Lights are Working

  N/A

Electrical System 120-volt AC and 12-volt DC (Interior Coach)

• Power demand for this unit (Amp Requirement)

  20 Amp - 120v

  30 Amp - 120V

  50 Amp - 240v

• Hot-Skin Test

  Pass

  Fail

  N/A

• 120-volt Power Cord Inspected

  Pass

  Fail

  N/A

• Electrical Panel Box - Any signs of prior repair or service

  Yes

  No

  N/A

• Electrical Panel Box - All circuit breakers in place

  Yes

  No

  N/A

• Electrical Panel Box - Any signs of Discoloration from Heat

  Yes

  No

  N/A

• Electrical Panel Box - All wiring secure

  Yes

  No

  N/A

• Electrical Panel Box - All White, Black, and Ground wires are kept separate

  Yes

  No

  N/A

• Fuse Panel Side in Good Condition

  Yes

  No

  N/A

• All fuses tested and operational

  Yes

  No

  N/A

• Identify which fuse failed the test.

• All wires tight and secure

  Yes

  No

  N/A

• Polarity / Voltage/GFCI Test - All Exterior Receptacles

  Yes

  No

  N/A

• Polarity / Voltage/GFCI Test - Receptacles in Storage Bay Areas

  Yes

  No

  N/A

• Polarity / Voltage Test - Bedroom Receptacles

  Yes

  No

  N/A

• Polarity / Voltage Test - Receptacle Behind Refrigerator

  Yes

  No

  N/A

• Polarity / Voltage/GFCI Test - Kitchen Receptacles

  Yes

  No

  N/A

• Polarity / Voltage Test - Living Room Receptacles

  Yes

  No

  N/A

• Polarity / Voltage Test - Dining Area Receptacles

  Yes

  No

  N/A

• Polarity / Voltage/GFCI Test - Bath and Toilet Area Receptacles

  Yes

  No

  N/A

• Polarity / Voltage Test - Receptacles Behind all Electronics and<br>Appliances

  Yes

  No

  N/A

• Power Converter - AC On: DC Voltage Reading w/ Shore Power On

• Power Converter - AC Off: DC Voltage Reading w/ Shore Power Off

• Power Converter - Verified:

  Good

  Fair

  Poor

  N/A

Generator

• Is There a Generator on board the Unit

  Yes

  No

  N/A

• Generator - Brand

  Onan

  Cummins

  Generac

  Other

• Brand name

• Generator - Model Number

• Generator - Serial Number

• Generator - Hours of Operations

• Generator - Radiator reservoir and hoses condition

  Good

  Fair

  Poor

  N/A

• Generator - Transfer Switch

  Good

  Fair

  Poor

  N/A

• Generator - Fuel Level Greater than 1/4 Tank(Shared Coach tank)

  Yes

  No

  N/A

• Generator - Oil Level at the proper level

  Yes

  No

  N/A

• Generator - Starts and Runs without issues

  Yes

  No

  N/A

• Generator - Tested Under Load

  Yes

  No

  N/A

• Define the reason for the no load test.

• Generator – Radiator appears to be in good condition

  Yes

  No

  N/A

• Generator - Oil Analysis Performed

  Yes

  No

  N/A

• Sample #

• Generator - Coolant Analysis Performed

  Yes

  No

  N/A

• Sample #

Inverter (12v DC to 120v AC)

• Is There an Inverter on This Unit

  Yes

  No

  N/A

• Inverter - Brand

  Xantrex

  Magnum

  Other

• Name of Brand

• Inverter - Model Number

• Inverter - Serial Number

• Inverter - Inspected Cables, Wiring and Fuses

  Yes

  No

  N/A

• Inverter - General Condition

  Good

  Fair

  Poor

  N/A

• Is There a 12-volt DC House Battery(s)

  Yes

  No

  N/A

• 12-Volt DC House Battery(s) - Location

• 12-Volt DC House Battery(s) - Box Condition

  Good

  Fair

  Poor

  N/A

• 12-Volt DC House Battery(s) - Cables and Terminal Conditions

  Good

  Fair

  Poor

  N/A

• 12-Volt DC House Battery(s) - Vented and Secured

  Good

  Fair

  Poor

  N/A

• 12-Volt DC House Battery(s) - Matched for Size and Age

  Yes

  No

  N/A

• 12-Volt DC House Battery(s) - Indication of recent Service

  Yes

  No

  N/A

• 12-Volt DC House Battery(s) – Type of Batteries

  Select Lead Acid Gel-cell AGM(Absorbed Glass Mat) Maintenance Free Other N/A

  • Lead Acid
  • Gel-cell
  • AGM(Absorbed Glass Mat)
  • Maintenance Free
  • Other
  • N/A

• Was a specific gravity test conducted

  Yes

  No

  N/A

• What was the High and low reading? Define which battery(s) had cells below average

Water Systems

• Was a full water pressure test completed for 15 minutes and passed? (80 - 100 psi)

  Yes

  No

  Unit Winterized Not Tested

• Was a Fixture Flood Test Conducted on all Fixtures (Fill Each 50% and observe drainage)

  Yes

  No

  Unit Winterized Not Tested

• Was a Full Flood Test of the Drain System Completed?

  Yes

  No

  Unit Winterized Not Tested

• Operation and Condition of Outside Shower

  Good

  Fair

  Poor

  N/A

• Operation and Condition of Kitchen Faucet

  Good

  Fair

  Poor

  N/A

• Operation and Condition of Bathroom Faucet

  Good

  Fair

  Poor

  N/A

• Operation and Condition of Shower

  Good

  Fair

  Poor

  N/A

• Operation and Condition of Toilet

  Good

  Fair

  Poor

  N/A

• Operation and Condition of Washer

  Good

  Fair

  Poor

  N/A

• Was a System Drain test performed on all drains and did they all pass

  Yes

  No

  N/A

• Explain why not

• On-Board Water System - Tested Fresh Water Fill:

  Yes

  No

  N/A

• Define reason not tested

• On-Board Water System - Pump Creates and Holds Pressure

  Yes

  No

  N/A

• On-Board Water System - Pressure System Works

  Yes

  No

  N/A

• Black Water Tank #1 - Valve Operates:

  Yes

  No

  N/A

• Black Water Tank #1 - Tank or Valve or Line Leaks

  Yes

  No

  N/A

• Black Water Tank #1 - Drain Cap in Place

  Yes

  No

  N/A

• Black Water Tank #1 Drain Cap Holds Waste Water Back

  Yes

  No

  N/A

• Was a Full Flood Test Performed on Black Water Tank #1

  Yes

  No

  N/A

• Black Water Tank #1 - Did Black Water Tank #1 Pass Full Tank Flood Test

  Yes

  No

  N/A

• Record Indicated Water Level on Monitor When Full

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is There additional Black Water Tanks

  Yes

  No

  N/A

• Black Water Tank #2 - Valve Operates:

  Yes

  No

  N/A

• Black Water Tank #2 - Tank or Valve or Line Leaks

  Yes

  No

  N/A

• Black Water Tank #2 - Drain Cap in Place

  Yes

  No

  N/A

• Black Water Tank #2 - Drain Cap Holds Waste Water Back

  Yes

  No

  N/A

• Was a Full Flood Test Performed on Black Water Tank #2

  Yes

  No

  N/A

• Black Water Tank #2 - Did Black Water Tank #2 Pass Full Tank Flood Test

  Yes

  No

  N/A

• Record Indicated Water Level on Monitor When Full

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Gray Water Tank #1 - Drain Cap in Place

  Yes

  No

  N/A

• Gray Water Tank #1 - Drain Cap Holds Gray Water Back

  Yes

  No

  N/A

• Gray Water Tank #1 - Valve Operates

  Yes

  No

  N/A

• Gray Water Tank #1 - Tank or Valve or Line Leaks

  Yes

  No

  N/A

• Was a Full Flood Test Performed on Gray Water Tank #1

  Yes

  No

  N/A

• Gray Water Tank #1 - Did Gray Water Tank #1 Pass Full Tank Flood Test

  Yes

  No

  N/A

• Record Indicated Water Level on Monitor When Full

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is There additional Gray Water Tanks

  Yes

  No

  N/A

• Gray Water Tank #2 - Drain Cap in Place

  Yes

  No

  N/A

• Gray Water Tank #2 - Drain Cap Holds Gray Water Back

  Yes

  No

  N/A

• Gray Water Tank #2 - Valve Operates

  Yes

  No

  N/A

• Gray Water Tank #2 - Tank or Valve or Line Leaks

  Yes

  No

  N/A

• Was a Full Flood Test Performed on Gray Water Tank #2

  Yes

  No

  N/A

• Gray Water Tank #2 - Did Gray Water Tank #2 Pass Full Tank Flood Test

  Yes

  No

  N/A

• Record Indicated Water Level on Monitor When Full

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is There additional Gray Water Tanks

  Yes

  No

  N/A

• Gray Water Tank #3 - Drain Cap in Place

  Yes

  No

  N/A

• Gray Water Tank #3 - Drain Cap Holds Gray Water Back

  Yes

  No

  N/A

• Gray Water Tank #3 - Valve Operates

  Yes

  No

  N/A

• Gray Water Tank #3 - Tank or Valve or Line Leaks

  Yes

  No

  N/A

• Was a Full Flood Test Performed on Gray Water Tank #3

  Yes

  No

  N/A

• Gray Water Tank #3 - Did Gray Water Tank #3 Pass Full Tank Flood Test

  Yes

  No

  N/A

• Record Indicated Water Level on Monitor When Full

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is There additional Gray Water Tanks

  Yes

  No

  N/A

• Gray Water Tank #4 - Drain Cap in Place

  Yes

  No

  N/A

• Gray Water Tank #4 - Drain Cap Holds Gray Water Back

  Yes

  No

  N/A

• Gray Water Tank #4 - Valve Operates

  Yes

  No

  N/A

• Gray Water Tank #4 - Tank or Valve or Line Leaks

  Yes

  No

  N/A

• Was a Full Flood Test Performed on Gray Water Tank #4

  Yes

  No

  N/A

• Gray Water Tank #4 - Did Gray Water Tank #4 Pass Full Tank Flood Test

  Yes

  No

  N/A

• Record Indicated Water Level on Monitor When Full

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is There additional Gray Water Tanks

  Yes

  No

  N/A

Monitoring Systems

• Battery monitor reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Fresh water tank reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Black water tank #1 reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is there a second Black Tank

  Yes

  No

  N/A

• Black water tank #2 reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Gray water tank #1 reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is there a second Gray water tank

  Yes

  No

  N/A

• Gray water tank #2 reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is There a Third Gray water tank

  Yes

  No

  N/A

• Gray water tank #3 reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Is there a Fourth Gray water tank

  Yes

  No

  N/A

• Gray water tank #4 reading

  Select Empty 1/3 2/3 1/4 1/2 3/4 Full Unable to Determine Not Present or Digital

  • Empty
  • 1/3
  • 2/3
  • 1/4
  • 1/2
  • 3/4
  • Full
  • Unable to Determine
  • Not Present or Digital

• Did All Monitor Reading Pass the (Full) Flood Tests and (Empty) Drain Tests

  Yes

  No

  N/A

• Was Propane Detector Tested

  Yes

  No

  N/A

• Propane Detector Test results

  Pass

  Fail

  N/A

• Propane Detector Make

• Model

• Serial Number

• Propane Detector Date

• Propane Detector Test method

  Select Spraying or releasing LP or Butane Pushing Test Button and Spraying LP or Butane Not Tested

  • Spraying or releasing LP or Butane
  • Pushing Test Button and Spraying LP or Butane
  • Not Tested

• Test Carbon monoxide Detector

  Yes

  No

  N/A

• Was the CO Detector Tested

  Yes

  No

  N/A

• CO Detector Make / Model /Serial Number

• CO Detector Date

• CO Detector Test method

  Select Spraying or releasing LP or Butane Pushing Test Button and Spraying LP or Butane Not Tested

  • Spraying or releasing LP or Butane
  • Pushing Test Button and Spraying LP or Butane
  • Not Tested

• Was Smoke Detector Tested

  Yes

  No

  N/A

• Smoke Detector Test results

  Pass

  Fail

  N/A

• Smoke Detector Make

• Model

• Serial Number

• Smoke Detector Date

  Date

• Smoke Detector Test method

  Canned Smoke

  Test Button

• Was the Fire Extinguisher Present (1A: 10B:C) 2.5lb

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Is the Extinguisher at its Proper Charge

  Yes

  No

  N/A

• Visual condition of tank(s)

  Good

  Fair

  Poor

  N/A

• Condition of mounts, brackets, and bolts

  Good

  Fair

  Poor

  N/A

• What is the fuel level a the time of inspection

• What is the listed capacity of each tank

• Confirm the proper installation of the regulator(s)

  Pass

  Fail

  N/A

• Was a System Operation Pressure Test performed

  Yes

  No

  N/A

• Initial pressure reading of system with 50% load

• Was an adjustment needed for the regulator

  Yes

  No

  N/A

• What was the pressure adjusted to

• What was the reading for the Pressure Lockup Test

• Was the Lockup pressure within specifications

  Yes

  No

  N/A

• What was the result of the test

  Pass

  Fail

  N/A

• Was a Time Pressure Test Performed

  Yes

  No

  N/A

• What was the pressure at the beginning of the test

• What was the pressure at the end of the 15 minute test

• What was the result of this test

  Pass

  Fail

  N/A

• Was a Bubble Leak Test performed after all test equipment was removed

  Yes

  No

  N/A

• What was the result of this test

  Pass

  Fail

  N/A

• Is the LP tanks the DOT type

  Yes

  No

  N/A

• What is the manufacturer of the ASME tank

• What was the Date of Manufacture

  Date

• Is the regulator cover installed

  Yes

  No

  N/A

• Is there an "Extended-A-Stay" valve installed

  Yes

  No

  N/A

• For DOT tanks, what is the configuration

  Select Single Dual Dual Split System Triple Quad None

  • Single
  • Dual
  • Dual Split System
  • Triple
  • Quad
  • None

• What is the size of cylinder #1

  20-lb

  30-lb

  40-lb

  Other

• Are there additional Cylinders

  Yes

  No

  N/A

• What is the size of cylinder #2

  20-lb

  30-lb

  40-lb

  Other

• Are there additional Cylinders

  Yes

  No

  N/A

• What is the size of cylinder #3

  20-lb

  30-lb

  40-lb

  Other

• Are there additional Cylinders

  Yes

  No

  N/A

• What is the size of cylinder #4

  20-lb

  30-lb

  40-lb

  Other

• Condition of all flexible hoses and connections

  Good

  Fair

  Poor

  N/A

Interior Photos

• Front to Rear

  Media

• Rear to Front

  Media

• Front Streetside

  Media

• Center Streetside

  Media

• Rear Streetside

  Media

• Front Curbside

  Media

• Center Curbside

  Media

• Rear Curbside

  Media

• Ceiling - Condition

  Good

  Fair

  Poor

  N/A

• Ceiling - Panels Loose

  Yes

  No

  N/A

• Ceiling - Discoloration or Stains

  Yes

  No

  N/A

• Ceiling - Trim Work Missing or Damaged

  Yes

  No

  N/A

• Ceiling Vents - All 12volt DC Fans Operate

  Yes

  No

  N/A

• Ceiling Vents - All 120Volt AC Fans Operate

  Yes

  No

  N/A

• Ceiling Vents and Skylights - Thermostatic Controls and Switches Work

  Yes

  No

  N/A

• Ceiling Vents and Skylights - Any Stains around Roof Vents or Skylitghts

  Yes

  No

  N/A

• Ceiling Vents and Skylights - Condition of Vents and Skylights

  Good

  Fair

  Poor

  N/A

• Lights and Light Fixtures - Do all 12volt DC Lights Function

  Yes

  No

  N/A

• Lights and Light Fixtures - Do all 120volt AC lights Function

  Yes

  No

  N/A

• Lights and Light Fixtures - Do all Wall Mounted Lights Work

  Yes

  No

  N/A

• Lights and Light Fixtures - Do all Rope Lights Function

  Yes

  No

  N/A

• Lights and Light Fixtures -Do all Spot Lights Function

  Yes

  No

  N/A

• Lights and Light Fixtures - Do all Floor Lights Work

  Yes

  No

  N/A

• Lights and Light Fixtures - Do all interior Entry Lights Function

  Yes

  No

  N/A

• Lights and Light Fixtures - Are there any missing or broken lenses

  Yes

  No

  N/A

• Walls - General Condition of walls

  Good

  Fair

  Poor

  N/A

• Walls - Any loose Panels

  Yes

  No

  N/A

• Walls - Any Water damaged wall panels

  Yes

  No

  N/A

• Walls - Any Panels Discolored or Stained

  Yes

  No

  N/A

• Walls - Any Soft Spots on Walls

  Yes

  No

  N/A

• Walls - Is All Trim Work on Walls

  Yes

  No

  N/A

• Walls - Any Damage Repairs Performed on Walls

  Yes

  No

  N/A

• Walls - Any Holes or Wall Repairs Needed

  Yes

  No

  N/A

• Closets and Pantries - Condition of Closets and Pantries

  Good

  Fair

  Poor

  N/A

• Closets and Pantries - Any Door Damage

  Yes

  No

  N/A

• Closets and Pantries - Wood Rot or Broken

  Yes

  No

  N/A

• Closets and Pantries - Any Drawer Damage

  Yes

  No

  N/A

• Windows - All Windows Function

  Yes

  No

  N/A

• Windows - Emergency Exit Windows Installed

  Yes

  No

  N/A

• Windows - Are All Emergency Exit Windows Functional

  Yes

  No

  N/A

• Windows - Condition of All Windows

  Good

  Fair

  Poor

  N/A

• Are There Sheet Vinyl Floors

  Yes

  No

  N/A

• Flooring - Condition of Sheet Vinyl

  Good

  Fair

  Poor

  N/A

• Are There Carpeted Floors

  Yes

  No

  N/A

• Flooring - Condition of Carpet

  Good

  Fair

  Poor

  N/A

• Are There Ceramic Tile Floors

  Yes

  No

  N/A

• Flooring - Condition of Ceramic Tile

  Good

  Fair

  Poor

  N/A

• Are There Plank Floors

  Yes

  No

  N/A

• Flooring - Condition of Plank Flooring

  Good

  Fair

  Poor

  N/A

• Flooring - Are There Floor Panels Loose

  Yes

  No

  N/A

• Flooring - Floor Covering Discolored or Stained

  Yes

  No

  N/A

• Flooring - Signs of Water Damage

  Yes

  No

  N/A

• Flooring - Sheet Vinyl Stained

  Yes

  No

  N/A

• Flooring - Soft Spots in the Floor

  Yes

  No

  N/A

• Flooring - Any Previous Repairs Performed that are Visable

  Yes

  No

  N/A

• Kitchen Sink - Type/Material

  Stainless Steel

  Aluminum

  Porcelin

  Plastic

  Other

• Kitchen Sink - Style

  Single Bowl

  Double Bowl

  Triple Bowl

• Kitchen Sink - Faucet Fully Works (Swivels, Extends, Etc)

  Yes

  No

  N/A

• Kitchen Sink - Faucet Leaks at Stem

  Yes

  No

  N/A

• Kitchen Sink - Signs of Water Damage Under the Sink

  Yes

  No

  N/A

• Kitchen Sink - Sink(s) Stopper Holds Water in Sink

  Yes

  No

  N/A

• Kitchen Sink - Hot and Cold Water is on the Correct sides

  Yes

  No

  N/A

• Toilet - Are there Water Leaks

  Yes

  No

  N/A

• Toilet - Bowl Holds Water

  Yes

  No

  N/A

• Toilet - Any Indication of Previous Damage

  Yes

  No

  N/A

• Shower / Tub - Any Stains in Stalls

  Yes

  No

  N/A

• Shower / Tub - Water Damage or Leaks

  Yes

  No

  N/A

• Shower / Tub - Is there a Glass Door

  Yes

  No

  N/A

• Shower / Tub - Condition of the Glass Door

  Good

  Fair

  Poor

  N/A

• Shower / Tub - Soap Dish in Place

  Yes

  No

  N/A

• Shower / Tub - Door Latch Functional

  Yes

  No

  N/A

• Shower / Tub - Towel Racks in Place

  Yes

  No

  N/A

• Shower / Tub - Curtain with Rod

  Yes

  No

  N/A

• Bathroom Sink - Style/Configuration

  Single Bowl

  Double Bowl

  Triple Bowl

• Bathroom Sink - Type/Material of Sink

  Plastic

  Porcelin

  Aluminum

  Other

• Bathroom Sink - Faucet Is Functional

  Yes

  No

  N/A

• Bathroom Sink - Faucet Leaks at Stem

  Yes

  No

  N/A

• Bathroom Sink - Water Damage Under the Sink

  Yes

  No

  N/A

• Bathroom Sink - The Sink Holds Water with Stopper in Place

  Yes

  No

  N/A

• Bathroom Sink - Hot and Cold Water is on the Correct Sides

  Yes

  No

  N/A

• Is This Unit a MotorHome

  Yes

  No

  N/A

• Was a Drive Test Performed on the Unit

  Yes

  No

  N/A