Operations Equipment Evaluation Form
Operations Equipment Evaluation Form
Instructions for Use: Complete all sections of this form accurately and thoroughly to evaluate equipment function and standards. Assign scores based on the assessment criteria, and provide detailed comments or actions required for scores below 3. Sign and date the form upon completion and submit it to the designated department head for review and follow-up actions.
General Information
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Evaluation Date |
Equipment Name |
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Model/Serial No. |
Department/Unit |
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Evaluator Name |
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Assessment Type |
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Evaluation Scores
The following criteria are evaluated on a scale of 1 (Poor) to 5 (Excellent). Any criteria marked below 3 requires immediate attention.
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Criteria |
Score |
Comments / Actions Required |
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Performance
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Safety and Compliance
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Maintenance and Reliability
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User-Friendliness
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Cost-Effectiveness
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Additional Observations
Recommendations
[Evaluator’s Signature]
[Month Day, Year]
[Department Head’s Signature]
[Month Day, Year]
