Road Maintenance Field Assessment Form
Road Maintenance Field Assessment Form
Date of Assessment
*
-
Month
-
Day
Year
Date
Inspector Name
*
Road/Location ID
*
General Road Surface Condition
*
Good
Fair
Poor
Shoulder Condition
*
Good
Fair
Poor
Drainage Assessment
*
1
2
3
4
5
Vegetation Control (e.g., overgrowth, visibility)
*
1
2
3
4
5
Signage Condition
*
All signs intact and visible
Some signs damaged or obscured
Majority of signs missing/damaged
Assessment Table: Rate the following aspects
Rows
Excellent
Good
Fair
Poor
Pavement Markings
1
2
3
4
Guardrails
5
6
7
8
Litter/Debris
9
10
11
12
Additional Comments or Observations
Submit Assessment
Should be Empty: