Rd1924-12

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USDA
Form RD 1924-12
(Rev. 1-00)

FORM APPROVED

INSPECTION REPORT

OMB No. 0575-0042

STATE

FOR

COUNTY

ADDRESS
PERCENT
COMPLETE

ITEM OF DEVELOPMENT

PERIODIC INSPECTION

ITEM OF DEVELOPMENT

PERCENT
COMPLETE

Date & No. of previous inspection:
This inspection is Number

ITEMIZE AND DESCRIBE the significant conditions observed to be at variance with the approved plans and specifications and make
your recommendations for correcting the deficiencies. Also make comments with respect to the progress of the work. In the case of
development performed by the borrower method, carefully compare work accomplished with funds available and record any facts
which indicate that actual costs are significantly at variance with planned costs. Check to see that deficiencies previously reported have
been corrected.

(See attached sheets for additional comments)

SIGNED

DATE

Indicate whether:

Agency Representative, or
Contractor

FINAL INSPECTION

I CERTIFY that I have inspected for the purposes set forth in 7 C.F.R. 1924 subpart A and 7 C.F.R. 1942 subpart A, the above
listed items of development and that those shown as 100% complete have been completed in accordance with the Drawings and
Specifications or other descriptive material. Health Department approval has been given the water and waste disposal system
Builder's Warranty is dated

on (date)

SIGNED

DATE

USDA Representative

The undersigned gives approval of acceptance of the work constructed under the conditions of the contract and Builder's Warranty.
DATE

SIGNED

DATE

SIGNED

Borrower
Builder (Optional)

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control
number. The valid OMB control number for this information collection is 0575-0042. The time required to complete this information collection is estimated to
average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information.

POSITION 6

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GUIDE FOR INSPECTION OF CONSTRUCTION OF
DWELLINGS AND BUILDINGS
Notices, Labor and Occupancy Observations.
Yes

NO

-

The required posters displayed?

Yes

NO

-

The facilities segregated?

Yes

NO

-

Amy evidence of employment discrimination?

GENERAL. - Drainage conditions. Location of buildings with respect

DRYWALL. - Joints, sanding, filling, taping.

to property lines: Other buildings, water supply, sewage disposal,
utilities, etc. Protection of materials on site.

GLAZING. - Quality of glass, putty, application.

EXCAVATION. - Earth bearing. Footing depths. Frost lines. Grades
specified.
CONCRETE AND MASONRY. -

LATHING AND PLASTERING. - Quality of lath, evenness, grounds,

joints between work and masonry, finishing.

Concrete mix or strength, forms, placing.
Mortar mix. Width and depth of footings. Reinforcing steel. Stepped
footings. Drain title. Concrete slabs on ground: Bed under slabs, wire
mesh, slab thickness, finish. Termite protection. Foundation wall and
pier alignment. Anchorage preparation. Dampproofing.
Waterproofing. Exterior masonry: Lintels, wall thickness, height,
parging, furring, wall vents, basement windows, termite protection,
Masonry veneer: Lintels, thickness, airspace, flashing, felt, bonding,
weepholes. Interior masonry wall: Thickness, lintels. All masonry
walls: Joints, tooling, pointing, flashing, prevention of mortar stains,
cleaning, Masonry chimney and fireplaces: Flues, size of flues, height
above ridge, thimble, chimney cap, smoke cap, smoke chambers,
firebrick, hearth. Basementless areas: Clearance below joist, positive
drainage.
CARPENTRY MATERIALS. - Species and grade of lumber, moisture
content. Shims. Preservatives.

MISCELLANEOUS METALWORK. - Pipe rail, metal bucks, metal

FRAMING. - Fire stopping. Framing at chimney. Columns. Posts.

PAINTING AND DECORATING. - Surface preparation, washable

Anchorage and moisture protection. Girders. Floor joists, double
joists. Headers and trimmers. Subflooring. Ceiling joists. Roof pitch.
Roof rafters. Hip and valley rafters. Collar beams. Flat roofs. Trussed
roof construction. Studs, corner construction, corner bracing. Sill
construction. Anchorage. Window and door openings. Plates. Wall
sheathing. Roof sheathing. Termite protection.

materials, lead content, application (suitable weather), nail heads.

EXTERIOR WALL FINISH. -Type of paper or felt. Lap. Fit at: Comer

FINAL. - Cleaning up: Masonry, crawl and pipe space, pipe chases,

boards, door and window casings, drip cap, water table, sills, Nails
and nailing. Miter. Comer finish. Stucco.

attic, vents in walls, floors, chimney bottoms, fireplace throat, glass,
hardware and fixtures. Removal of debris. Closing of floor openings
around pipes. Replacement of broken windows. Operation of doors
and windows.

ROOF COVERING. - Conditions of deck, underlay, starting course,

windows (setting, caulking and priming), painting.
MILLWORK. - Trim, cabinets, windows and doors, thresholds.
WEATHER STRIPPING. - Seal, joints (tight and smooth).
FINISH FLOORS. - Dry storage, baseboard clearance, joints, nailing,

finish, protection after laying.
SCREENING. - Screen cloth, tightness, fit, operation, identification

tags, paint splashes.
HARDWARE. - Materials, workmanship, operation, keys.
LIGHTING FIXTURES. - Type, bulbs (light, clean).

BACKFILLING. - Around masonry, around trees. Finish grade 8 inches

below wood.
LANDSCAPING. - Planting, seeding, finish grades.

exposure, nailing.
INSULATION. - Fastening of boards. Fill (to top of walls and even

distribution in ceilings).
FLASHING AND CAULKING. - Flashing at: exterior heads of

openings, chimneys, intersections of roof and walls, valleys, hips,
ridges. Caulking around openings
PLUMBING. - Quality of materials Workmanship. Excavation and

backfill. Protection of pipes. Size of pipe. Cutting or notching. Joints
and connections. Water supply lines: On solid ground below frost,
shut- off valve, drain valve for entire system. Drainage system, vents
and venting. Traps and clean outs. Hangers and supports. Quality and
type of fixtures. Location of fixtures. Fixtures securely installed.
Domestic hot water heating and storage, equipment, safety, capacity.
HEATING. - Safety, capacity. Required tests, operating and

maintenance instruction. Fuel storage. Check operation.

WATER SUPPLY

Location with respect to possible sources of contamination. Shaft.
Protection from contamination. Construction. Watertight casing safe
distance above slab and safe distance below ground surface. Grading
at top of well to drain away in all directions. Size of concrete
platform. Slope of concrete platform. Pump: Type, capacity, location,
protection, pollution proof, frost proof. Capacity of pressure tank.
SEWAGE DISPOSAL

Location: Slope of grade, depth of ground water, existing and future
water supply. Size and slope of house sewer to septic tank. Capacity
of tank. Distance of tank from foundation wall. Construction of tank,
Location of disposal field (unobstructed and unshaded area).
Construction of field. Minimum seepage area (determined by
percolation test or recommendation of Soil Conservation Service and
State Board of Health). Approval of State Board of Health.

GAS (Liquefied Petroleum). - Approval markings on tank. Tank

Location. Meter installation (hung properly). Protection of exposed
pipe. Leakage under pressure (smell joints). Location of shut-off
valve inside building. Proper ventilation of system.
ELECTRICAL. - Location of meter. Number of circuits. Provision for

future circuits. Location of outlets and switches. Power suppliers
approval.

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RD 1924-12
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