General Earthquake Damage

Inspection Checklist
Where description is requested, if necessary, attach additional pages of
notes and photographs keyed to the appropriate checklist item.

. General Information
1. Property Ow er’s Name:

2. of Property: perty:

City: State: Zip:

CA

3. Date of Inspection :

4. Inspector’s Name:

B. General Building and Site Information

When Yes is marked, consider if a technical consultant is warranted.

5. Building Department Safety Assessment Tag:

Comments:

.
a. dor of natural gas leakage?

b. ed e e

a e e a de bee ef ed ce e ea a e
f e de c be

C-2 C: General Earthquake Damage Inspection Checklist CEA-EDA-01

 House Number:

8. Building Site:
Flat

. Building Configuration: (check all that apply)

Single story
Combination one story and two story
Three story
Split level
Living space above garage
Other
f e de c be

. Exterior Wall Finishes: . Roof Configuration:

Stucco Gable
Panel siding Hip
Lap siding Flat or very low slope
Masonry veneer Shed
Other Other
f e de c be f e de c be

2. Foundation Configuration: 3. Roof Covering:

Slab-on-grade Asphalt shingles
Crawlspace without cripple walls Wood shingle or shake
Crawlspace with cripple walls Concrete or clay tile
Exposed piers or posts at perimeter Metal shingles
Partial basement Membrane
Full basement Other
Other f e , describe:
f e de c be

C.. Exterior Inspecti

When Yes is marked, consider if a technical consultant is warranted. The N/A response option stands for Not Applicable.

14. General: (if yes, provide description and photos)

a. Collapse, partial collapse, or building off foundation?

b. b e ea a

15. Geotechnical Issues: (if yes, provide description and photos)

a. Signs of fresh cracking in or movement of hardscape?

b. Signs of fresh cracking in or movement of retaining walls?

c. Evidence of sand boils or other fresh-appearing deposits of sand or mud

d. Evidence of rock falls or slope instability at site?

e. Ground movement or wet areas indicating possible broken underground e

CEA-EDA-01 C: General Earthquake Damage Inspection Checklist C-3

 House Number:

1 . Exterior Walls: (if yes, provide description and photos)

Yes a. Fresh cracking at door corners or window openings?

b. e c ac a b d c e

c. d e ac ed f ae

d. e a d d

e. a ea

f. de a a f cc

. a e f c ac a e e d f e d face ef da a da a

. de ce f ece ea e e e a d e

. ca ee ee e cc c f efa d e ef da
e e c ac f cc a e d e e acc a ed b d ca f e a e
d ace e d f eb d ea e ef da

. a e a a c a e e aa f a e ee e e e c ac e aa
ff e a b d d c e

. e e e c ac e aa ff e a b d d c e

1 .
a. Fresh cracking of exposed perimeter foundation?

b. ea e e e be ee ab a d f ab ade f da

c. a e e bee e ca e f ed

d. f e e a e f ed eeb added c ec e e ef da

e. f e e a e f ed a d e ea added a c e a de
e e

f. f e e a e f ed a d e a d a d e a c e ed ea e de c be e

. f e e a e f ed a ea a e c e ed

C-4 C: General Earthquake Damage Inspection Checklist CEA-EDA-01

 House Number:

18. Chimney: (if yes, provide description and photos)

a. e e e e a

b. e e a e ca

c. a e a a c a e

d. b e da a e c ac

e. be e aa f b d

f. f ed eca f e e e e a dd aced a

. ee a fe ed a

. e e f ec e c e ed

19.

a. f ed d d ed c a c cee f e

b. ac da a e ff a fa c e

c. aced f ec a ca e ec ca e e

d. f ca a f d e e

e. f e e be ee af e a a d a f e a ea e

f. c ed d d ed f a ea f f e ba ea c e f a e ec
add a e da e c e e b d e a e

. ea f f e ba e dec ae f a ee a c e

. f da a e ea a e a ef ea e ec ca e f f ec a ca
e e

. f f da a e a a e

CEA-EDA-01 C: General Earthquake Damage Inspection Checklist C-5

 House Number:

0. Attached or Abutting Improvements: (if yes, provide description and photos)

a. a e a a c a e e aa f a ac ed c e ca a c e
a

b. de ce f ece e e e d ace e fe e e a a a ea e
eb d

c. f e e be ee b d f aa ef a de e a d ca e ea
a a e de f e ee e

d. f da a e ea a e a ef ea e ec ca e f ec a ca
e e

1. Independent Exterior Improvements: (if yes, provide description and photo

a. a a ed de ac ed a a e

b. a a e fe ce ac a

c. a a e ea a

d. a a e dec

e. de ce f ea a e f a e

f. f da a e ea a e a f e c ec f a e a

. e f f ae e

. e e c e da a e

. c d ba e e a d a ac ed a a e f e e
When Yes is marked, consider if a technical consultant is warranted. The N/A response option stands for Not Applicable.

22.
f e acce b e de f ea

Typical wall and ceiling finishes:

C-6 C: General Earthquake Damage Inspection Checklist CEA-EDA-01

 House Number:

.
a. e c ac b c a de ac e f e a f e a d c e a d
d e

b. e c ac f a f e a a c e a ce e ec

c. d e ac ed f ae

d. a ea

e. a e f c ac a e e d f ef ab a a

f. e e d f a ea e ef

. e e e c ac e aa ff e a b d e a e

. da a ed d ff c eae e ab e

. d da a ed d ff c eae e ab e

4. Ceilings: (if yes, provide description and photos)

a. a e f ce f e

b. e c ac f ce f e e ec a a ee a c e c ac a c e bead a
a e e c ac ea ff e a ce a c e e a

c. a a e ce f e c fc e f e ace

d. e aa c ac ce f e a e e ee a c e add a e da e
e b d d c e

e. a e da a e e de ce f ece ea a e f b e f

5. Floors: (if yes, provide description and photos)

a. de ce f ece a e e e d ace e ff

b. ab ade ca fe c ac ff ab f f e

c. f ca a a b c e f dfa ef e ca ace

d. e aa c ac f f e a e e ee a c e add a e da e
e b d e a e

e. f e e be ee f c d aa ef a de e a d ca e ea a
a e de f e ee e

f. a e ffe c ac a e aa f f e

. ac da a e f f e f fa c e

CEA-EDA-01 C: General Earthquake Damage Inspection Checklist C-7

 House Number:

26. Fireplace: (if yes, provide description and photos)

a. a e a a c a e e aa f e f e ace fac f e e
ea e ad ace a f f eb

b. ffe e a e e be ee f e ace e a d f eb

. Mechanical and Plumbing Systems: (if yes, provide description and photos)

a. aced c ec fa a ce f e c ec ed c e

b. f da a e ea a e a ae ea e d aced f e c ec da a e
ea a e a a e e ec ca c ec

c. f da a e ea a e a a e f ec ec e ec ca c ec ef ea e
c de aeda c ec f f ace a c d fa c

d. a a e a e f a e a f e ed c e d e

e. a a e e

f. ec ea ed e c ed ae e ea a a ce fa ce e

. f f f ee a d d e f e

. f da a e ea a e a f e c ec ff e a

28. Architectural Woodwork and Special Finishes: (if yes, provide description and photos)

a. f f da a e c e ba cab e

b. ac da a e c e f fa b ec

c. ac f ce a c e b e e e c e c e ea a e da a e
ad ace a f e

. Contingent Inspections
9. Is a crawlspace present? (if yes, see the Crawlspace Checklist)

0. Is an attic present? (if yes, see the Attic Checklist)

F. Conclusions
31. Based on this inspection, should use of a technical consultant be considered?
If yes, which question(s) drove this decision:

f e de c be e ea

C-8 C: General Earthquake Damage Inspection Checklist CEA-EDA-01

 House Number:

32.

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