Historic Site Equipment Assessment Form
Please complete this form to assess the condition and needs of equipment at the historic site.
Site Name and Location
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessor Full Name
*
First Name
Last Name
Assessor Email Address
*
example@example.com
Equipment Inventory
*
Rate the condition and functionality of each equipment item listed above. Use the scale: 1 = Poor, 5 = Excellent.
Rows
Condition
Functionality
Equipment 1
1
2
Equipment 2
3
4
Equipment 3
5
6
Equipment 4
7
8
Equipment 5
9
10
Are any equipment items missing or unaccounted for?
*
No, all equipment is accounted for.
Yes, some items are missing (please specify below).
If equipment items are missing or unaccounted for, please list them here.
Does any equipment require maintenance or repair?
*
No, all equipment is in working order.
Yes, maintenance/repair is needed (please specify below).
Describe any maintenance or repair needs identified.
Are there any safety concerns related to the equipment?
*
No safety concerns.
Yes, there are safety concerns (please specify below).
Please provide details about any safety concerns.
Upload photos or documents related to the assessment (optional).
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Additional Comments or Recommendations
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