Equipment Check Field Assessment Form
Complete this form to assess equipment condition, functionality, safety, and required actions during field inspections.
Equipment Name or ID
*
Location of Equipment
*
Inspector Name
*
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Equipment Type
*
Please Select
Generator
Pump
Compressor
Electrical Panel
Valve
Other
Overall Equipment Condition
*
1
2
3
4
5
Functionality Status
*
Operational
Partially Operational
Non-Operational
Safety Compliance
*
Compliant
Minor Issues
Major Issues
Component Checklist
*
Rows
Pass
Fail
N/A
Power Supply
1
2
3
Controls
4
5
6
Connections
7
8
9
Safety Guards
10
11
12
Lubrication
13
14
15
Actions Required / Comments
Submit Assessment
Should be Empty: