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Residential Roof Inspection FormInspection Date:Inspector:Structure InformationStructure ID:Used For:Job No.:Year Roof Applied:Structure Description:PermanentTemporaryBuilding Type:Resident Key Contact Name:Owner/Mgr. Contact (ifdifferent):Structure Address:Owner/Mgr. Phone:Structure City/ST/ZipOwner/Mgr. ofing Company Contact InformationRoofing Contractor Company:Roofing Co. Address:Roofing Company Contact:Roofing Co. City/ST/ZIP:Roofing Company 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?NoHas occupancy or use of the building changed since last inspection?Yes - Attach copy of guarantee to this recordNoYes - Describe:Have any changes, additions or new penetrations been made to roof since last inspection?NoHas there been leakage?WindNoYes - Describe Conditions:Light RainHeavy RainYes - Describe:Leaks ContinuouslyOther:Were emergency repairs performed?NoYes - Describe:2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.orgPage 1
Residential Roof Inspection FormCodeConditionG Good, No ActionF Fair, Monitor PeriodicallyP Poor, Immediate ActionGFPLocationAction TakenInteriorRoof DeckA1CorrosionA2Spalling (chipping or crumbling)A3CrackingA4BucklingA5SaggingA6Open JointsA7General Deck SettlingB3CracksB4Spalling (chipping or crumbling)B5Paint PeelingB6Water StainsB100Other:ExteriorWallsC1Deteriorated Mortar Joints2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.orgPage 2
Residential Roof Inspection FormCodeConditionG Good, No ActionF Fair, Monitor PeriodicallyP Poor, Immediate ActionGC2Settlement CracksC3StainsC4EfflorescenceC5WindowsC7Fascia DisplacedFPLocationAction TakenMetal FlashingsCounter FlashingE1Loose/Missing FastenersE2Loose/Displaced MetalE3Deformed MetalE4CorrosionE6Sealant iners/Clamping RingL2Clear of DebrisL3FlashingL4Overall CleanlinessL5Gutter AnchorsL6Drains/DownspoutsL7Gutter General ConditionL100Other:2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.orgPage 3
Residential Roof Inspection FormCodeConditionG Good, No ActionF Fair, Monitor PeriodicallyP Poor, Immediate ActionGFPLocationAction TakenPenetrationsGeneralK1Pitch Pocket SealantK2Loose FlashingK3DrawbandsK100Other:Conduit or PipeN1SaggingN2Supports ngO11Granule AdhesionO12Standing Water2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.orgPage 4
Residential Roof Inspection FormCodeConditionG Good, No ActionF Fair, Monitor PeriodicallyP Poor, Immediate ActionGO13VandalismO14Foot Traffic DamageO17Mechanical DamageO18Exposed Felt/DeckO19Hail DamageO100Other:FPLocationAction TakenMiscellaneousR1AntennasR2Guy WiresR3Ice or IciclesR4Oil DepositsR5Surface ContaminationR6Soft AreasR7VandalismR8Vegetative GrowthR100Other:Photographic RecordU1Film/Digital PhotograpyU2VideoU100Other:*Mark all items with the appropriate code on the roof plan grid. Keep copies of inspection forms and photographic or other evidencewith the Roof Historical Record.2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.orgPage 5
2002O Residential Roof Inspection Form wMidwest Roofing Contractors Association w800/497-6722 wwww.mrca.org Page 5 Code Condition G Good, No Action F Fair, Monitor Periodically P Poor, Immediate Action G F P Location Action Taken O13 Vandalism O14 Foot Traffic Damage O17 Mechanical Damage O18 Exposed Felt/Deck
