Chance Technical Design Manual

SITE INSPECTION FORM

Customer Name:

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POTENTIAL MAJOR GEOLOGICAL HAZARDS Location of faults _ ____________________________________ Stability of hillside _____________________________________ Flood plain location _ __________________________________ Potential for excessive water runoff due to future development ____________________________________________________ SITE CONDITIONS Slope of the land_ _____________________________________ Configuration of fill wedge______________________________ Depth of rock_________________________________________ Depth of water table_ __________________________________ Examination of nearby creeks____________________________ Examination of nearby house_ ___________________________ Condition of roadway adjacent to house (potential slab creep & slope failure problems)_ ________________________________ Examination of road curbs_ _____________________________ General Topography_ __________________________________ Surface Drainage_ _____________________________________ ACCESSIBILITY Equipment Access on site?_ _____________________________ Head-room (If interior install)_ ___________________________ What length of extensions are needed?____________________ Does homeowner want to:  Lift structure  Stabilize Areas to avoid (gardens, patios, etc.) _ ____________________ FOUNDATION CONDITION Foundation Type:  Basement  Crawl space  Slab-on-grade Foundation construction:  Block  Stone  Mono-block General appearance of foundation_ _______________________ Map cracks in foundation_ ______________________________ Proximity of trees to foundation__________________________ Gutter and downspouts_________________________________ Water in crawl space_ __________________________________ STRUCTURAL CONDITION Examination of roof-line to detect general movement_ _______ Openings square_ _____________________________________ Cracks in plaster around opening_ ________________________ Cracks around windows and doors (put on sketch)___________ Floor level, may require levels conducted_ _________________ Construction of home: ________ Brick: _______ Frame: _________ Age: ___________ ___________________ Floor system construction (include description of framing, joist size, and spacing)_ ____________________________________ Structure has been previously piered:  Yes  No

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