Sample Technical Field Rating Sheet Properties

Texas Weatherization Assistance Program Technical Field Rating Sheet March 2010

Program Year ______Date ______House # ______$______

______Dwelling Type Job # ______Single Family Assessor Name: ______Mobile Home Contractor/Crew Address ______Multi Family Final Inspector ______Funding Source______

Assessment  Improvement needed  Acceptable  Unacceptable  Call Back required  Final Inspection  Improvement needed  Acceptable  Unacceptable  Call Back required  Health & Safety Assessment Work Final Inspection Smoke Detector – CO Detector- LSW – Gas Stoves------Comments:

Diagnostics – (Blower Door/Air Sealing) Pre Weather @ 50Pa ______Assessment Work Final Inspection Intermediate @ 50Pa ______Post Weather @ 50Pa ______Target ______Could Not Perform ______BTL ______Stories ______Comments:

Attics Unfinished – Finished Kneewall –------Assessment Work Final Inspection Insulation – Vents (High-Low) – Adequate Ventilation-- Hatch Boxed – Barriers--Insulation Cert. Posted – Knob and Tube Comments:

Walls Assessment Work Final Inspection Insulation -- Knob and Tube ------Comments:

Foundation - (Floor) Assessment Work Final Inspection Insulation –Crawl-Vapor Barrier-Slab--Repairs-Crawl-Scuttle Door Adequate Ventilation Comments:

Windows Pane/Frame Caulk – Glass Replacement-Glazing-Adjust Sash Lock- Assessment Work Final Inspection Glass Replacement –Replacement-Storm Windows Comments:

Windows-Mobile Home Assessment Work Final Inspection Drip Cap- Insider Storm-Replacement ------Comments: Doors Assessment Work Final Inspection Weatherstrip-Sweep-Pane/Frame Caulk-Replacement------Lock-Set-Hinges-Adjustment Striker Plate- Comments:

Furnace Assessment Work Final Inspection Clean & Tune – Replacement-Repair- Thermostat ------Gas Shutoff-LP Gas Line-(Black or Copper)- Comments:

Water Heater Assessment Work Final Inspection Gas Shutoff-Replacement-Discharge Pipe------Revent W/H-Elec. Comments:

Baseload Measures Assessment Work Final Inspection CFL’s- Refrigerators- Water Savers------Comments:

Air Conditioning Assessment Work Final Inspection Duct System- Filters- Return Air Comments:

Energy Repair Assessment Work Final Inspection Roof ------Electrical------Repair ------Other------Comments:

Audit Priority List

Program Officer: ______Date:______