Water Risk Assessment Checklist Form
Complete this checklist to record site water risks, current conditions, overall risk level, and any follow-up actions needed.
Site and Assessment Details
Site or Facility Name
*
Site Location or Area
*
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Assessor Name or Role
*
Water Risk Checklist
Water Risk Conditions
*
Rows
Present
Absent
Standing water
1
2
Leaks or seepage
3
4
Drainage issues
5
6
Flooding signs
7
8
Blocked drains
9
10
Poor runoff management
11
12
Water intrusion
13
14
Other site-specific water hazards
15
16
Drainage and Water Flow Compliance
*
Rows
Compliant
Non-compliant
Surface drainage functioning as intended
17
18
Runoff directed away from structures
19
20
Drain outlets clear and unobstructed
21
22
No evidence of ponding near access routes
23
24
Water flow controls in place and effective
25
26
Observed Water Hazard Indicators
Ponding
Damp surfaces
Mold or mildew
Erosion from water flow
Overflow evidence
Other
Additional Water Hazards or Checklist Notes
Overall Risk and Follow-Up
Overall risk rating
*
Low
Medium
High
Critical
Current control measures or corrective actions needed
*
Follow-up status
Please Select
No follow-up needed
Monitor
Action required
Urgent escalation
Submit
Should be Empty: