Telescopic Inspection Camera Equipment Check Form
Complete this form to document the condition and status of telescopic inspection camera equipment before and after use.
Operator Full Name
*
First Name
Last Name
Date of Inspection
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Equipment Serial Number or ID
*
Inspection Type
*
Pre-Use Inspection
Post-Use Inspection
Overall Equipment Condition
*
Excellent
Good
Fair
Poor
Component Checklist
*
Rows
OK
Needs Attention
Not Applicable
Camera Head
1
2
3
Cable/Reel
4
5
6
Monitor/Display
7
8
9
Battery/Charger
10
11
12
Lighting/LEDs
13
14
15
Carrying Case
16
17
18
Control Panel
19
20
21
Are there any visible damages or malfunctions?
*
No issues found
Yes (describe below)
Describe any issues, damages, or actions taken (if applicable)
Upload photos of equipment or issues (if applicable)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional Comments or Notes
Inspector Signature
*
Submit Inspection
Submit Inspection
Should be Empty: