Author: Chris & Brad Keiper

Notes/Flags (HHS use): R/O CGCart

Client: Address:
State/Prov: Months: J F M A M J J A S O N D

Door to Enter Enter Premises: yes, each visit / no, exterior only
Open Interior Water Valves yes, running water no, not running water
Location of Exterior Water Valves Post only Secondary valve :
Status of Power to home Will be on Will be off Turn on and off Fridge: ON /OFF
Location of power breakers Post, plus Primary: Other :
Status of climate control not used a/c or heat will be on at
Special Requests
Cycle Appliances Yes / No Specifics: Washer / Dryer Dishwasher (white vinegar) Disposal (3-in-1 oil)
Flush Reverse Osmosis unit
Auto on Premises Yes / No Start Auto
Golf Cart on Premises Yes / No Check and Fill Golf Cart Batteries Plug in and Charge Golf Cart
Run Irrigation thru Manual Check Water plants by hand Details of outdoor work
General Well-Being / Other Details
Hot Water Tanks
Number: 1 / 2 / 3 Access? Yes / No Location(s):
Date checked: N/A Status: OK / corrosion or rust / dripping or leaking / cannot access / needs work now

BASIC
Exterior visual
Check carport awning for separation
Interior check on well-being
Check ceilings for leaks
Make sure windows are locked
Check window shields

REGULAR
Exterior visual
Check carport awning for separation
Turn on water
Interior check on well-being
Circulate water
Check under sinks for leaks
Check toilets and check for leaks
Fill water buckets
Fill traps with Antifreeze
Check ceilings for leaks
Make sure windows are locked
Check window shields
Check fridge
Check climate control is working
Turn off water

INTENSIVE
Exterior visual
Check carport awning for separation
Turn on water
Interior check on well-being
Circulate water
Check under sinks for leaks
Check toilets and check for leaks
Fill water buckets
Fill traps with Antifreeze
Check ceilings for leaks
Make sure windows are locked
Check window shields
Check fridge
Check climate control is working
Turn off water
Cycle Appliances

* V1 Date: __ Initials: Int OK / Ext OK / Weeds / Notes: ______
* V2 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V3 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V4 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V5 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V6 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V7 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V8 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V9 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V10Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V11Date: Initials: Int OK / Ext OK / Weeds / Notes: ________
* V12Date: Initials: Int OK / Ext OK / Weeds / Notes: ________

Notes/Flags (HHS use): R/O CGCart

Client: Address:
State/Prov: Months: J F M A M J J A S O N D

Door to Enter Enter Premises: yes, each visit / no, exterior only
Open Interior Water Valves yes, running water no, not running water
Location of Exterior Water Valves Post only Secondary valve :
Status of Power to home Will be on Will be off Turn on and off Fridge: ON /OFF
Location of power breakers Post, plus Primary: Other :
Status of climate control not used a/c or heat will be on at
Special Requests
Run Appliances Yes / No Specifics: Washer / Dryer Dishwasher (white vinegar) Disposal (3-in-1 oil)
Flush Reverse Osmosis unit
Auto on Premises Yes / No Golf Cart on Premises Yes / No Start Auto Check and Fill Golf Cart Batteries Plug in and Charge Golf Cart
Run Irrigation thru Manual Check Water plants by hand Details of outdoor work
General Well-Being / Other Details
Hot Water Tanks
Number: 1 / 2 / 3 Access? Yes / No Location(s):
Date checked: N/A Status: OK / corrosion or rust / dripping or leaking / cannot access / needs work now

Normal Stick Built House
Exterior visual
Check carport awning for separation
Turn on water
Interior check on well-being
Circulate water
Check under sinks for leaks
Check toilets and check for leaks
Fill water buckets
Fill traps with Antifreeze
Check ceilings for leaks
Make sure windows are locked
Check window shields
Check fridge
Check climate control is working
Turn off water
Run Appliances

* V1 Date: __ Initials: Int OK / Ext OK / Weeds / Notes: ______
* V2 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V3 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V4 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V5 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V6 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V7 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V8 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V9 Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V10Date: Initials: Int OK / Ext OK / Weeds / Notes: ______
* V11Date: Initials: Int OK / Ext OK / Weeds / Notes: ________
* V12Date: Initials: Int OK / Ext OK / Weeds / Notes: ________