Residential Roof Inspection Form
Inspection Date: |
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Inspector: |
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Structure Information
Structure ID: |
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Used For: |
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Job No.: |
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Year Roof Applied: |
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Structure Description: |
Permanent |
Temporary |
Building Type: |
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Single-family |
Apartments |
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Multi-family |
Other: |
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Resident Key Contact Name: |
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Owner/Mgr. Contact (if |
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different): |
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Structure Address: |
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Owner/Mgr. Phone: |
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Structure City/ST/Zip |
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Owner/Mgr. E-Mail: |
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Roofing Company Contact Information
Roofing Contractor Company: |
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Roofing Co. Address: |
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Roofing Company Contact: |
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Roofing Co. City/ST/ZIP: |
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Roofing Company Phone: |
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Roofing Co. E-Mail: |
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Previous Maintenance and Repair Work
(Briefly describe membrane and flashing work done, including dates and who did the work)
Date of Last Inspection: |
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Is the Roof guaranteed? |
No |
Yes - Attach copy of guarantee to this record |
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Has occupancy or use of the building changed since last inspection? |
No |
Yes - Describe: |
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Have any changes, additions or new penetrations been made to roof since last inspection? |
No |
Yes - Describe: |
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Has there been leakage? No |
Yes - Describe Conditions: |
Light Rain |
Heavy Rain |
Wind |
Leaks Continuously |
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Other: |
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Were emergency repairs performed? No |
Yes - Describe: |
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2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.org 
Page 1
Residential Roof Inspection Form
Code |
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Condition |
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G = Good, No Action |
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F = Fair, Monitor Periodically |
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P = Poor, Immediate Action |
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G |
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Location |
Action Taken |
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Interior |
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Roof Deck |
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A1 |
Corrosion |
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A2 |
Spalling (chipping or crumbling) |
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A3 |
Cracking |
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A4 |
Buckling |
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A5 |
Sagging |
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A6 |
Open Joints |
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A7 |
General Deck Condition |
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A8 |
Stains/Drips |
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A100 |
Other: |
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Walls |
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B1 |
Movement |
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B2 |
Settling |
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B3 |
Cracks |
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B4 |
Spalling (chipping or crumbling) |
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B5 |
Paint Peeling |
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B6 |
Water Stains |
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B100 |
Other: |
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Exterior |
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Walls |
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C1 |
Deteriorated Mortar Joints |
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2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.org 
Page 2
Residential Roof Inspection Form
Code |
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Condition |
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G = Good, No Action |
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F = Fair, Monitor Periodically |
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P = Poor, Immediate Action |
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G |
F |
P |
Location |
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Action Taken |
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C2 |
Settlement Cracks |
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C3 |
Stains |
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C4 |
Efflorescence |
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C5 |
Windows |
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C7 |
Fascia Displaced |
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Metal Flashings |
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Counter Flashing |
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E1 |
Loose/Missing Fasteners |
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E2 |
Loose/Displaced Metal |
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E3 |
Deformed Metal |
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E4 |
Corrosion |
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E6 |
Sealant Joints |
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E7 |
Punctures |
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E100 |
Other: |
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Drains/Downspouts |
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L1 |
Strainers/Clamping Ring |
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L2 |
Clear of Debris |
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L3 |
Flashing |
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L4 |
Overall Cleanliness |
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L5 |
Gutter Anchors |
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L6 |
Drains/Downspouts |
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L7 |
Gutter General Condition |
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L100 |
Other: |
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2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.org 
Page 3
Residential Roof Inspection Form
Code |
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Condition |
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G = Good, No Action |
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F = Fair, Monitor Periodically |
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P = Poor, Immediate Action |
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G |
F |
P |
Location |
Action Taken |
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Penetrations |
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General |
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K1 |
Pitch Pocket Sealant |
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K2 |
Loose Flashing |
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K3 |
Drawbands |
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K100 |
Other: |
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Conduit or Pipe |
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N1 |
Sagging |
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N2 |
Supports Moving |
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N3 |
Joints |
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N4 |
Corrosion |
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N100 |
Other: |
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Membrane/Shingle |
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General |
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O1 |
Discoloration |
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O2 |
Coating/Surfacing |
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O3 |
Cracking |
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O4 |
Wrinkles |
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O5 |
Punctures |
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O9 |
Delamination |
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O10 |
Alligatoring |
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O11 |
Granule Adhesion |
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O12 |
Standing Water |
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2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.org 
Page 4
Residential Roof Inspection Form
Code |
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Condition |
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G = Good, No Action |
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F = Fair, Monitor Periodically |
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P = Poor, Immediate Action |
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G |
F |
P |
Location |
Action Taken |
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O13 |
Vandalism |
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O14 |
Foot Traffic Damage |
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O17 |
Mechanical Damage |
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O18 |
Exposed Felt/Deck |
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O19 |
Hail Damage |
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O100 |
Other: |
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Miscellaneous |
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R1 |
Antennas |
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R2 |
Guy Wires |
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R3 |
Ice or Icicles |
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R4 |
Oil Deposits |
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R5 |
Surface Contamination |
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R6 |
Soft Areas |
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R7 |
Vandalism |
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R8 |
Vegetative Growth |
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R100 |
Other: |
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Photographic Record |
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U1 |
Film/Digital Photograpy |
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U2 |
Video |
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U100 |
Other: |
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*Mark all items with the appropriate code on the roof plan grid. Keep copies of inspection forms and photographic or other evidence with the Roof Historical Record.
2002O Residential Roof Inspection Form w Midwest Roofing Contractors Association w 800/497-6722 w www.mrca.org 
Page 5