| PROBLEM |
DESCRIPTION |
REPAIR NEEDED |
| |
|
|
| WINDOWS |
|
|
| Missing/torn screens |
|
|
| Broken/cracked glass |
|
|
| Missing/torn storms |
|
|
| Missing/broken locks |
|
|
| Air comes in |
|
|
| Other window problems: |
|
|
| DOORS |
|
|
| No deadbolt locks |
|
|
| Broken locks |
|
|
| Broken/missing doorknobs |
|
|
| Other door problems: |
|
|
| WALLS/CEILINGS/FLOORS |
|
|
| Chipped or flaking paint |
|
|
| Holes or cracks in walls |
|
|
| Leaky roof or ceiling |
|
|
| Holes in carpet |
|
|
| Broken/missing tiles/linoleum |
|
|
| Dirty carpet |
|
|
| Dirt/stains on walls |
|
|
| Other problems: |
|
|
| PLUMBING |
|
|
| Clogged pipes/toilet |
|
|
| Toilet doesn't flush properly |
|
|
| Dripping faucets |
|
|
| No hot water |
|
|
| Water not hot enough |
|
|
| Other water/plumbing problem |
|
|
| APPLIANCES |
|
|
| Stove/oven |
|
|
| Refrigerator |
|
|
| Other |
|
|
| ELECTRICAL |
|
|
| Bare/exposed wiring |
|
|
| No switch/socket plate |
|
|
| Short circuits/bad fuses |
|
|
| Lights flicker |
|
|
| Other electrical problems: |
|
|
| FURNACE/HEAT |
|
|
| No enough or no heat |
|
|
| Gas fumes leak |
|
|
| Thermostat doesn't work |
|
|
| Broken vent fan |
|
|
| Other heat/ventilation problem |
|
|
| SAFETY PROBLEMS |
|
|
| Smoke detector broken/missing |
|
|
| Building open to strangers |
|
|
| Need window locks |
|
|
| Non-residents loitering around the building;
when/where |
|
|
| Other safety problems: |
|
|
| INFESTATIONS |
|
|
| Mice |
|
|
| Cockroaches |
|
|
| CONDITION OF FIXTURES |
|
|
| Bathroom/kitchen sink |
|
|
| Bathroom/kitchen cabinets |
|
|
| Bathroom tub/shower |
|
|
| Other: |
|
|
| COMMON AREAS |
(HALLWAYS,STAIRS, GROUNDS) |
|
| Bad/not enough lighting |
|
|
| Bad cleaning/maintenance |
|
|
| Chipping, peeling paint |
|
|
| Loose/dangerous stair railings |
|
|
| Smoke detectors missing/broke |
|
|
| Elevator problems |
|
|
| Broken doors/fences |
|
|
| Broken sidewalks/driveway |
|
|
| Play area not maintained |
|
|
| Laundry equipment not maintained |
|
|
| Other: |
|
|
Other comments:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
The landlord and tenant agree that the tenant did not cause the damage stated above,
and that the landlord will make the necessary repairs as indicated on this checklist
within 30 days of this signing:
TENANT: _________________________________ DATE: _____________
LANDLORD: ______________________________ DATE: ______________
Address of Rental Unit:__________________________
__________________________
cc: copies should be made for tenant and landlord's records
| 
