Geothermal Heat Pump System Inspection Form
Site & Inspector Information
Date
Inspector Name
Site Location
System Details
System Type
Closed Loop
Open Loop
Hybrid
Model Number
Serial Number
Visual Inspection
Unit Condition
Good
Fair
Poor
Visible Leaks
None
Present
Pipe/Connection Integrity
Intact
Loose
Damaged
Electrical Connections
Secure
Loose
Damaged
Air Filter Condition
Clean
Needs Replacement
Antifreeze Level/Condition
Adequate
Low
Contaminated
Operational Inspection
Heating Mode Function
Pass
Fail
Cooling Mode Function
Pass
Fail
Pump Operation
Normal
Abnormal
Thermostat Operation
Proper
Improper
Unusual Noises
None
Present
System Pressure
Notes / Comments
Inspector Signature
Signature
Date