Concrete Surface Evaluation Form
Use this form to comprehensively evaluate and document the condition of concrete surfaces. Please complete all sections for a thorough assessment.
Inspector Name
*
First Name
Last Name
Evaluation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Project or Location
*
Type of Concrete Surface
*
Please Select
Floor
Wall
Ceiling
Slab
Pavement
Other
Overall Surface Condition
*
Excellent
Good
Fair
Poor
Observed Defects (Select all that apply)
Cracking
Scaling
Spalling
Discoloration
Efflorescence
None
Other
Detailed Comments or Notes
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of
Signature
Submit Evaluation
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