Information

  • Jobsite

  • Area

  • Conducted on

  • Prepared by

  • Location
  • Personnel

    Room

Plumbing/HVAC Piping

  • Valves are accessible

  • All piping systems have been tested

  • All piping systems have been inspected

  • Piping is insulated and insulation shields are installed

  • Valve tags are installed

  • Pipes are properly labeled

  • Graded pipe has the proper slope

  • Pipes are properly supported

  • Seal pipes through wall and floors

  • Access doors are installed

  • Medical gas piping is isolated from dissimilar metals

  • Roof drain bodies are properly insulated

  • High point vents and low point drains are installed

  • Drain pans are installed and piped where required

  • Service access is provided for equipment above the ceiling

  • Control wiring is complete

  • Medical gas alarm wiring is complete

  • Piping does not pass through stairs and stair passageways

  • Piping is not installed above electrical panels

Sheetmetal

  • Fire - Fire/Smoke Damper flashing has been installed and checked

  • Access doors have been installed, labeled, and verified accessible

  • Duct is properly supported

  • Duct has been sealed and tested as required

  • Service access is provided for equipment above the ceiling

  • Duct is insulated through the walls

  • The ends of duct are covered

  • Duct does not pass through stairs and stair passageways

  • Duct is not installed above electrical panels

  • Duct insulation is properly installed and sealed

  • Grilles are insulated where required

  • Grilles are covered to keep the duct clean

  • Volume dampers have been flagged

  • Wall penetrations have been properly caulked

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.