Anchor Installation Checklist Form
Complete this checklist to document and verify all steps of an anchor installation job.
Installation Site / Project Name
*
Work Order or Job Reference Number
*
Installer Name
*
First Name
Last Name
Installation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Anchor Type
*
Please Select
Mechanical Expansion
Chemical/Adhesive
Undercut
Screw
Other
Anchor Location (Room/Area/Coordinates)
*
Substrate / Surface Type
*
Please Select
Concrete
Masonry
Steel
Drywall
Other
Required Load / Capacity (kN or lbs)
*
Anchor Quantity Installed
*
Installation Method
*
Please Select
Drill and Set
Cast-in Place
Chemical Injection
Other
Tools / Equipment Used
Rotary Hammer Drill
Torque Wrench
Vacuum / Dust Extractor
Measuring Tape
Other
Hole/Drill Diameter (mm or in)
Hole Depth (mm or in)
Anchor Spacing/Placement (mm or in)
Torque/Tightness Verification
*
Verified with Torque Wrench
Hand Tightened
Not Verified
Inspection Result
*
Passed
Passed with Comments
Failed
Issues / Defects Noted
Corrective Actions Taken (if any)
Final Approval / Completion Status
*
Completed and Approved
Completed with Reservations
Not Completed
Submit Checklist
Should be Empty: