Geological Site Assessment Form
Please complete this form to document and evaluate geological site conditions, hazards, and recommendations.
Site Name or Identification Number
*
Location (Address or GPS Coordinates)
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Site
*
Please Select
Outcrop
Quarry
Construction Site
Slope/Embankment
Riverbank
Other
Assessment Objective
*
Dominant Geological Material
*
Bedrock
Soil
Gravel
Sand
Clay
Other
Site Stability & Hazard Indicators
*
Rows
None
Minor
Moderate
Severe
Landslide Evidence
1
2
3
4
Erosion
5
6
7
8
Rockfall
9
10
11
12
Flooding
13
14
15
16
Subsidence
17
18
19
20
General Site Condition (1 = Poor, 5 = Excellent)
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Key Observations
*
Recommendations or Next Steps
*
Submit Assessment
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