Public Infrastructure Sustainability Assessment Form
Assess the sustainability performance of public infrastructure using consistent ratings, comparison criteria, and improvement priorities.
Infrastructure Details
Infrastructure Name
*
Infrastructure Type
*
Road
Bridge
Transit Stop
Park
Utility Facility
Other
Location / Area Served
*
Managing Agency / Department
*
Sustainability Assessment
Overall sustainability rating
*
1
2
3
4
5
Sustainability dimensions assessment
*
Rows
1 - Very Poor
2 - Poor
3 - Fair
4 - Good
5 - Excellent
Energy efficiency
1
2
3
4
5
Water efficiency
6
7
8
9
10
Material durability
11
12
13
14
15
Maintenance efficiency
16
17
18
19
20
Accessibility
21
22
23
24
25
Environmental impact
26
27
28
29
30
Climate resilience
31
32
33
34
35
Assessment notes and key observations
Assessment Summary
Most urgent improvement priority
*
Please Select
Safety
Energy efficiency
Water conservation
Accessibility
Structural maintenance
Waste management
Other
Planned improvement timeline
*
Immediate
3-6 months
6-12 months
Later
Reviewer comments or recommendations
Submit
Should be Empty: