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Guide for Completing Form 8823 - page 85 / 197

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SITE: Fencing & Gates Grounds Mailboxes/Project Signs Parking Lots/Driveways/Roads Play Areas & Equipment Refuse Disposal Retaining Walls Storm Drainage Walkways/Stairs BUILDING SYSTEMS: Domestic Water Electrical System Elevators Emergency Power Exhaust System Fire Protection Heating/Ventilation/Air Conditioning

BUILDING EXTERIOR: Doors Fire Escapes Foundation Lighting Roof Walls Windows UNITS: Bathroom Call-For-Aid Ceiling Doors Electrical Systems Floors Heating/Ventilation/Air Conditioning Hot water Heater Kitchen

Sanitary System COMMON AREAS: Basement/Garage/Carport Closet/Utility/Mechanical Community Room Day Care Halls/Corridors/Stairs Kitchen Laundry Room Lobby Office Other Community Spaces Patio/Porch/Balcony Pools & Related Structures Restrooms Storage Trash Collection Area

Laundry Area (Room) Lighting Outlets/Switches Patio/Porch/Balcony Smoke Detectors Walls Windows HEALTH & SAFETY: Air Quality Electrical Hazards Elevator Emergency/Fire Exits Flammable Material Garbage and Debris Hazards Infestation Mold Lead-based Paint

Exhibit 6-1 Checksheet for the Physical Inspection of LIHC Properties

Severity of Violation

Items should be marked “1”, “2” or “3” to identify the severity level of the violation that reflects the extent of damage associated with the deficiency.

Development Name and Address:

Project #:

Name: Address:

Inspection Date: Asset Manager Conducting Inspection:

Physical Inspection Review Summary

Phone:

Finding

City/State/Zip C Owner Contact Fax #:

ode

Finding

Total # Bldgs/Units Inspected:

Lead Risk:

(Yes

/

No)

#/#

6-9

Revised October 2009

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