Standpipe Inspection Checklist Form
Complete this Standpipe Inspection Checklist Form to document the operational status and compliance of standpipes during routine inspections.
Inspection Date
*
-
Month
-
Day
Year
Date
Inspector Name
*
First Name
Last Name
Location of Standpipe
*
Standpipe Identification/Number
*
Physical Condition of Standpipe
*
Please Select
Good – No visible damage
Minor damage – Cosmetic only
Major damage – Needs repair
Valve Operation
*
Please Select
Operates smoothly
Stiff but operable
Inoperable – Requires attention
Signage and Labeling Present and Legible
*
Signage present
Labeling legible
Signage missing or damaged
Accessibility – Standpipe is unobstructed and accessible
*
Accessible
Partially obstructed
Obstructed – Needs clearing
Presence of Leaks or Corrosion
*
Please Select
No leaks or corrosion
Minor corrosion only
Leaks present
Additional Comments or Observations
Submit Inspection
Should be Empty: