Lead Monitoring Equipment Inspection Checklist Form
Complete this checklist to assess the condition, functionality, and readiness of lead monitoring equipment.
Inspector Name
*
First Name
Last Name
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment Serial Number
*
Is the equipment powered on and operational?
*
Yes
No
Calibration Status
*
Calibrated
Calibration Due
Not Calibrated
Battery Level
*
Full
Sufficient
Low
Needs Replacement
Sensor Functionality
*
All Sensors Functional
Some Sensors Faulty
No Sensors Functional
Physical Condition of Equipment (check all that apply)
*
Clean
No Visible Damage
Display/Readout Clear
Accessories Present
Other
Inspection Results Summary
Actions Required / Comments
Submit Inspection
Should be Empty: