Skid Resistance Monitoring Log Form
Log and assess skid resistance inspections for roads, pavements, walkways, and similar surfaces.
Inspector Name
*
First Name
Last Name
Date and Time of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of Inspection (e.g., road name, area, or coordinates)
*
Surface or Asset Inspected
*
Please Select
Roadway
Pavement
Walkway
Parking Area
Other
Weather Conditions During Inspection
*
Dry
Wet
Icy
Snowy
Other
Surface Condition Observed
Clean
Contaminated (oil, debris, etc.)
Worn
Damaged
Other
Test or Measurement Method Used
*
Please Select
Pendulum Tester
GripTester
SCRIM
British Pendulum Tester
Other
Skid Resistance Readings
Rows
Test Location/Point
Reading Value
1
2
3
4
5
Hazards or Defects Observed
None
Potholes
Cracking
Loose Material
Standing Water
Other
Condition Assessment
*
Acceptable
Requires Follow-up
Recommended Corrective Action
Additional Notes or Comments
Submit Log
Should be Empty: