Damp and Mould Inspection Survey

Damp and Mould Inspection Survey
Please complete this survey to assess and report on damp and mould conditions within the property.
Property Address*
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Inspection Date*
MonthDayYear
Date
Inspector Name*
First NameLast Name
Contact Email
example@example.com
Living RoomBedroomsKitchenBathroom(s)HallwaysOther
CondensationPenetrating DampRising DampBlack MouldWhite MouldOther
Severity and Extent by Area*
Rows Severity (1=Low, 5=High) Approximate Area Affected (sq ft)
Living Room
Bedrooms
Kitchen
Bathroom(s)
Hallways
Other
Poor VentilationLeaking Roof/GuttersPlumbing IssuesRising Damp from GroundCondensation from OccupancyOther
Rate the overall severity of damp/mould in the property*
Photos of affected areas (upload if available)
Cancelof
Actions taken during inspection (if any)
Recommendations for remedial action*
Should be Empty:

Rows	Severity (1=Low, 5=High)	Approximate Area Affected (sq ft)
Living Room
Bedrooms
Kitchen
Bathroom(s)
Hallways
Other