Historical Site Inspection Checklist Form
Complete this checklist to document the condition and compliance of a historical site during inspection.
Site Name
*
Site Address or Location
*
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
Overall Physical Condition
*
1
2
3
4
5
Structural Integrity
*
Excellent
Good
Fair
Poor
Compliance with Preservation Guidelines
Original materials preserved
No unauthorized alterations
Signage and markers intact
No visible damage
Other (please specify)
Safety Hazards Observed
Trip hazards
Unstable structures
Blocked exits
None observed
Other (please specify)
Immediate Actions Required?
*
Yes
No
Recommended Follow-up Actions
Submit Inspection
Should be Empty: