Engineering Services Checklists and Waivers
Fill out checklists by marking every item with ✓ or NA, and then email your completed checklist to the engineer that will do the inspection. The completed checklist must be returned to our office before the final inspection by MDH is made.
- Nursing Home Checklist - Physical Plant - New Construction (PDF)
- Construction Completion Checklist (PDF)
- Health Care Facility Life Safety Code Checklist (PDF)
Instructions for Completing a Waiver Form (PDF)
NOTE: For the best results use Microsoft Office 2013 or newer to complete the waiver forms.
- Notification for Ventilation of Surgical Suites (Word)
- Drinking Fountain (Word)
- Equivalency for 20% Relative Humidity in an Anesthetizing Location (Word) (created 12/15/17)
- Locked Unit Waiver Information, see Information Bulletin 91-1
- Neighborhood Kitchen(s) - Limited Food Preparation/Cooking (Word) (updated 12/15/17)
- Neighborhood Kitchen(s) - Range Hood with Extinguishing System (Word) (updated 12/15/17)
- Neighborhood Kitchen(s) - Under-Counter Dishwasher (Word)
- Toilet Location to Provide Staff Assistance (Word)