Wall Extraction Assessment Survey
Please complete this survey to assess the conditions and considerations for wall extraction at your site.
Project/Site Name
*
Assessor's Name
*
First Name
Last Name
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location of Wall within Site (e.g., Room, Floor)
*
Type of Wall
*
Please Select
Load-bearing
Non-load-bearing
Partition
External
Other
Wall Material
*
Brick
Concrete
Drywall
Wood
Stone
Other
Assessment of Wall Condition
*
Rows
Excellent
Good
Fair
Poor
Structural Integrity
1
2
3
4
Presence of Cracks
5
6
7
8
Moisture/Dampness
9
10
11
12
Previous Repairs
13
14
15
16
Observed Risks or Hazards (select all that apply)
Electrical wiring present
Plumbing present
Asbestos suspected
Structural instability
No significant risks observed
Other
Overall Feasibility of Wall Extraction
*
Feasible without major concerns
Feasible with precautions
Not recommended due to risks
Undetermined, further inspection needed
Recommendations or Additional Comments
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