Gas Water Heater Inspection Checklist Form
Use this Gas Water Heater Inspection Checklist Form to conduct a thorough inspection and record the condition and safety of the unit.
Inspector Name
*
First Name
Last Name
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Gas Water Heater Model and Serial Number
Visual Condition of Water Heater
*
No visible damage or corrosion
Minor wear or rust present
Significant damage/corrosion
Gas Line and Connections: Leak Check
*
No leaks detected
Minor leak detected
Major leak detected
Venting/Flue Condition
*
Properly installed and unobstructed
Partially obstructed or loose
Obstructed or disconnected
Pilot/Ignition System Operation
*
Operating correctly
Intermittent operation
Not operating
Temperature and Pressure Relief Valve
*
Tested and functioning
Not tested
Not functioning
Operational Test (Heater cycles on/off, heats water)
*
Passes operational test
Passes with issues
Fails operational test
Additional Comments or Recommendations
Submit Inspection
Should be Empty: