Information

  • Document No.

  • Conducted on

  • Conducted by

  • Location/Station
  • Room Number

Element 1 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 2 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 3 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 4 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 5 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 6 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 7 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 8 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 9 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 10 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 11 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 12 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 13 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 14 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 15 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 16 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 17 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 18 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 19 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 20 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 21 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 22 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 23 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 24 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 25 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 26 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 27 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 28 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 29 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

Element 30 Condition

  • Element Number

  • Photo

  • Is there any change in condition from last assessment?

  • Condition Grade

  • Confidence Grade (are you confident with your condition grade)

  • Assessment of Remaining Life

  • Quantity Unit

  • Quantity

  • Confidence Grade (are you confident with your quantity)

  • Health and Safety Risk - is this item a current H&S risk?

  • Immediate Action Required - Is immediate action required to repair or replace?

  • General Comments

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.