Lightning Protection Risk Assessment Form

Lightning Protection Risk Assessment Form
Evaluate and document the lightning protection risk factors for a facility or building.
Assessor Name
First NameLast Name
Assessment Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Facility/Building Name
Facility Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Facility
Building Height (meters)
Number of Occupants
Building Construction Material
Lightning Risk Factors Assessment
Rows Risk Level
Location prone to thunderstorms
Building isolated or tallest in area
Presence of sensitive electronic equipment
History of lightning strikes
Proximity to trees/tall structures
Overall Lightning Risk Rating

1
2
3
4
5
1 is Very Low, 5 is Very High
Existing Lightning Protection System?
Additional Comments or Recommendations
Should be Empty:

Rows	Risk Level
Location prone to thunderstorms
Building isolated or tallest in area
Presence of sensitive electronic equipment
History of lightning strikes
Proximity to trees/tall structures

Select theme: