Utility Asset Management Survey

Utility Asset Management Survey
Please complete this survey to help us assess and improve the management of your utility assets.
Organization Name
Contact Person Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Asset Location (Address)
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Asset
Asset Condition Assessment
Rows Excellent Good Fair Poor
Physical State
Operational Status
Safety Compliance
Maintenance History
How would you rate the criticality of this asset for your operations?

1
2
3
4
5
1 is Not Critical, 5 is Highly Critical
Risk Assessment: What are the main risks associated with this asset? (Select all that apply)
Other
How frequently is this asset maintained?
Please rate the adequacy of current asset management practices.
What improvements or investments are needed for this asset?
Additional Comments or Suggestions
Should be Empty:

Select theme: