Age (Yrs) Type: Air Conditioning Age (Yrs) Poor Fair Good Excellent Condensation Lines Age (Yrs) Poor Fair Good Excellent Water Heater Type Yes No Poor Fair Good Excellent Pan Present? Age (Yrs) Poor Fair Good Excellent Electric Supply Amperage AMP GFI: Type Supply: Service: Yes No Poor Fair Good Excellent ARC Fault Interrupter? Last Inspection Date PLUMBING Yes No Material ___________ Poor Fair Good Excellent Water Supply Lines: Yes No Poor Fair Good Excellent Curb Stops Last Inspection Date: Yes No Poor Fair Good Excellent Shut-off Valves Yes No Poor Fair Good Excellent Water Meters: Up to Code? Yes No Material _________________ Poor Fair Good Excellent Vent Stacks: ELECTRIC Yes No Poor Fair Good Excellent Underground Transmission Lines Yes No Poor Fair Good Excellent Aboveground Transmission Lines Last Inspected ________________ Yes No Poor Fair Good Excellent Meters: Yes No Poor Fair Good Excellent Electric Panels: Amps: Brand: Yes No Poor Fair Good Excellent Service Capacity Yes No Spare Breaker Capacity Yes No Site Lighting Adequate? Yes No ANY UNITS FINISHED BELOW GRADE? ASBESTOS PRESENT? Yes No NESHAP Environmental Yes No Yes No LEAD PAINT PRESENT? Certificate available? Yes No MOLD PRESENT? COMMON AREAS DETAIL/CONDITION INTERIOR STAIRS Poor Fair Good Excellent Yes No Meet code requirements?
Air Conditioning Age (Yrs) Type: Condensation Lines Age (Yrs) Poor Fair Good Excellent Water Heater Age (Yrs) Poor Fair Good Excellent Type Pan Present? Yes No Poor Fair Good Excellent Electric Supply Age (Yrs) Poor Fair Good Excellent Type GFI: Amperage Supply: AMP Service: ARC Fault Interrupter? Yes No Poor Fair Good Excellent Last Inspection Date PLUMBING Water Supply Lines: Material ___________ Yes No Poor Fair Good Excellent Curb Stops Yes No Poor Fair Good Excellent Last Inspection Date: Shut-off Valves Yes No Poor Fair Good Excellent Water Meters: Up to Code? Yes No Poor Fair Good Excellent Vent Stacks: Material _________________ Yes No Poor Fair Good Excellent ELECTRIC Underground Transmission Lines Yes No Poor Fair Good Excellent Aboveground Transmission Lines Yes No Poor Fair Good Excellent Meters: Last Inspected ________________ Yes No Poor Fair Good Excellent Electric Panels: Yes No Poor Fair Good Excellent Amps: Brand: Service Capacity Yes No Poor Fair Good Excellent Spare Breaker Capacity Yes No Site Lighting Adequate? Yes No ANY UNITS FINISHED BELOW GRADE? Yes No ASBESTOS PRESENT? Yes No NESHAP Environmental LEAD PAINT PRESENT? Yes No Certificate available? Yes No MOLD PRESENT? Yes No COMMON AREAS DETAIL/CONDITION INTERIOR STAIRS Poor Fair Good Excellent Meet code requirements? Yes No
2017-NHTF-Allocation-Plan-Final.docx