Site and Equipment Management Survey
Please provide feedback on site conditions, equipment status, and management practices to help us maintain safety and efficiency.
Site Name or Location
*
Contact Person Full Name
*
First Name
Last Name
Contact Email Address
*
example@example.com
Date of Survey
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type(s) of Equipment Present at the Site
*
Machinery
Electrical Systems
Safety Equipment
Vehicles
Tools & Accessories
Other
Rate the Condition of the Following Equipment
*
Rows
Excellent
Good
Fair
Poor
Machinery
1
2
3
4
Electrical Systems
5
6
7
8
Safety Equipment
9
10
11
12
Vehicles
13
14
15
16
Tools & Accessories
17
18
19
20
How often is equipment maintenance performed?
*
Please Select
Weekly
Monthly
Quarterly
Annually
As Needed
Not Sure
Are all safety protocols and signage in place and clearly visible?
*
Yes
No
Partially
Have there been any equipment malfunctions or safety incidents in the last 12 months?
*
No incidents
Yes, equipment malfunction(s)
Yes, safety incident(s)
Yes, both
Overall Satisfaction with Site and Equipment Management
*
1
2
3
4
5
Please provide any additional comments, suggestions, or details about issues encountered.
Submit Survey
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