Information

  • Document No.

  • Conducted on

  • Prepared by;

  • Please state

  • Select date

Location

  • Location
  • Town

  • Site classification

  • Site Name

Water Body

  • Pond type

  • Please state

  • Where on site - name/location?

  • Signage

  • Where & type

  • Is signage/extra signage needed?

  • Please state type & location

  • Is this replacing missing signage or new?

Photo of pond & surrounds

  • Photo

Water Surrounds

Looking North

  • Slope

  • Vegetation

Looking East

  • Slope

  • Vegetation

Looking South

  • Slope

  • Vegetation

Looking West

  • Slope

  • Vegetation

Usage

  • Fencing?

  • What percentage is fenced?

  • Type of fencing

  • Please state

  • Proximity of paths/access

  • Visibility of water body

  • Lighting

  • Amount of natural light

  • Activities involving water body

  • Please state

  • Litter present?

  • Please state:

  • Water Quality

  • Any signs of pollution?

  • Please state:

  • No other defects found at time of inspection

  • Please specify defects and action required:

  • Any other comments?

  • Please state:

Signature

  • Signature

  • Date & Time

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.