Borewell Inspection Report Form
Use this form to record borewell inspection details, findings, condition, issues, and recommended follow-up actions.
Inspection Details
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Inspector Name
*
First Name
Middle Name
Last Name
Inspector Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Site/Property Name
*
Site Address/Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Borewell ID / Reference Number
*
Borewell Type
*
Please Select
Open Well
Drilled Borewell
Tube Well
Other
Inspection Purpose
*
Routine Inspection
Pre-Purchase Assessment
Issue Investigation
Maintenance Check
Post-Repair Verification
Other
Inspection Purpose Details
Borewell Condition and Technical Findings
Borewell Depth (m)
*
Water Level Status
*
Normal
Low
Very Low
Dry
Not Measured
Pump / Functionality Status
*
Functioning
Intermittent
Non-Functioning
Needs Repair
Casing / Piping Condition
*
Good
Fair
Poor
Damaged
Needs Replacement
Yield / Flow Condition
*
Good
Reduced
Very Low
No Flow
Water Quality Observation
*
Clear
Slightly Turbid
Turbid
Discoloured
Odorous
Not Tested
Visible Contamination Signs
Algae Growth
Oil Sheen
Sediment Accumulation
Surface Water Ingress
Debris
No Visible Contamination
Structural Damage Signs
Cracks
Corrosion
Leakage
Loose Fittings
Collapsed Section
No Visible Damage
General Inspection Rating / Condition Score
*
1
2
3
4
5
Issues, Recommendations, and Follow-up
Observed Issues or Defects
*
Recommended Corrective Actions
*
Urgency / Priority Level
*
Low
Medium
High
Urgent
Estimated Repair or Maintenance Needs
Minor repair
Routine maintenance
Parts replacement
Further technical assessment
Other
Follow-up Inspection Required?
*
Yes
No
Expected Follow-up Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Final Remarks
Submit Report
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