Inspection Date: Inspector: Building Information Building ID: No.: Used For: Year Roof Applied: Building Description: Permanent Temporary Building Type: Retail Industrial Residential Building Name: Building Address: Building City/ST/Zip Building Contact: Building Phone: Building E-Mail: Key Contact Information Owner/Tenant: Owner/Tenant Contact: Owner/Tenant Address: Owner/Tenant City/ST/ZIP: Owner/Tenant Phone: Owner/Tenant E-Mail: Roofing Contractor: Roofing Co. Contact: Roofing Co. Address: Roofing Co. City/ST/ZIP: Roofing Co. Phone: Roofing Co. E-Mail: Previous Maintenance and Repair Work (Briefly describe membrane and flashing work done, including dates and who did the work) Date of Last Inspection: Is the Roof guaranteed? No Yes - Attach copy of guarantee to this record Has occupancy or use of the building changed since last inspection? No Yes - Describe: Have any changes, additions or new penetrations been made to roof since last inspection? No Yes - Describe: Has there been leakage? No Yes - Describe s: Light Rain Heavy Rain Wind Leaks Continuously Were emergency repairs performed? No Yes - Describe: Page 1
Code Interior Roof Deck A1 A2 A3 A4 A5 A6 A7 A8 A100 Spalling Cracking Buckling Sagging Open Joints Overall Deck Bitumen Drips Walls B1 B2 B3 B4 B5 B6 B100 Movement Settling Cracks Spalling (chipping or crumbling) Paint Peeling Water Stains Exterior Walls C1 Deteriorated Mortar Joints Page 2
C2 C3 C4 C5 C7 C8 C9 C10 C100 Settlement Cracks Stains Efflorescence Windows Fascia Displaced Gutter Anchors Downspouts Gutter General Metal Flashings Counter Flashing E1 E2 E3 E4 E5 E6 E7 E100 Loose/Missing Fasteners Loose/Displaced Metal Deformed Metal Loose/Missing Joint Cover Sealant Joints Coping/Cap Flashing F1 F2 F3 Loose/Missing Fasteners Loose/Displaced Metal Deformed Metal 2002M Midwest Roofing Contractors Association 800/497-6722 www.mrca.org Page 3
F4 F5 F6 F7 F8 F9 F100 Loose/Missing Joint Cover Cracked Sealant Cracked/Broken Coping Cap Open Coping Joint Expansion Joints G1 G2 G3 G4 G5 G6 G7 G8 G9 G10 G100 Loose/Missing Fasteners Loose/Displaced Metal Deformed Metal Loose/Missing Joint Cover Spliced Joints Stripped-in Flashing Splitting Mechanical Damage Hinders Drainage Edge Metal H1 H2 H3 H4 Loose/Missing Fasteners Loose/Missing Stripped-in Flashing Splits in Stripped-in Flashing Joints Page 4
H5 H6 H7 H8 H100 Loose/Missing Metal Sections Loose/Missing Joint Cover Open End Joints Sealant Joints Base Flashing J1 J2 J3 J4 J5 J6 J7 J8 J100 Exposed Top Seal Adhesion Seams/Attachment to Field Vertical Laps Deterioration Sagging/Wrinkling Excessive Bridging Penetrations General K1 K2 K3 K100 Pitch Pocket Sealant Loose Flashing Drawbands Drains L1 Strainers/Clamping Ring Page 5
L2 L3 L4 L100 Clear of Debris Flashing Overall Cleanliness Rooftop Equipment M1 M2 M3 M4 M5 M6 M100 Attachment to Curbs Access Panels Housing Liquid Discharge Condensation Roof Adjacent to Equipment Conduit or Pipe N1 N2 N3 N4 N100 Sagging Supports Moving Joints Membrane/Shingle General O1 O2 O3 Discoloration Coating/Surfacing Cracking Page 6
O4 O5 O6 O7 O8 O9 O10 O11 O12 O13 O14 O15 O16 O17 O18 O19 O100 Wrinkles Walkways, Displaced Walkways, Deteriorated Walkways, Needed Delamination Alligatoring Granule Adhesion Standing Water Vandalism Foot Traffic Damage Blistering Buckling Mechanical Damage Exposed Felt/Deck Hail Damage Laps P1 P2 P100 Open Joints Fishmouths Membrane Q1 Q2 Unadhered Areas Blisters Page 7
Q3 Q4 Q5 Q100 Loose Insulation Fasteners Backing Out Ridges Miscellaneous R1 R2 R3 R4 R5 R6 R7 R8 R100 Antennas Guy Wires Ice or Icicles Oil Deposits Surface Contamination Soft Areas Vandalism Vegetative Growth Coating General S1 S2 S3 S4 S5 S100 Reflectivity (Rating) Discoloration Adhesion Cracking/Peeling Crazing Page 8
Surfacing General T1 T2 T3 T4 T100 Type: Coverage/Bare spots Discoloration Gravel Stop Photographic Record U1 U2 U100 Film/Digital Photograpy Video *Mark all items with the appropriate code on the roof plan grid. Keep copies of inspection forms and photographic or other evidence with the Roof Historical Record. Page 9