Cavity Wall Inspection Form
Complete this checklist to assess the condition and findings of the cavity wall inspection.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Location / Address
*
Overall Condition of Cavity Wall
*
Good
Fair
Poor
Presence of Visible Defects
*
None
Minor Cracks
Major Cracks
Loose Bricks
Other
Moisture/Dampness Detected
*
No
Yes - Minor
Yes - Significant
Insulation Status
*
Intact and Effective
Partially Missing
Completely Missing
Ventilation Assessment
*
Adequate
Inadequate
Blocked
Detailed Defect Checklist
Rows
Present
Not Present
Wall Tie Corrosion
1
2
Cavity Blockage
3
4
Bridging
5
6
Efflorescence
7
8
Insulation Slumping
9
10
Overall Inspection Rating
*
1
2
3
4
5
Inspector's Observations and Recommendations
Submit Inspection
Should be Empty: