Noise Pollution Assessment Checklist
Assessment Location
Assessment Date
Assessor Name
Sources of Noise
Traffic (road, rail, air)
Construction Activities
Industrial Operations
Public Events/Entertainment
Other
Measured Noise Levels (dB)
Times of Noise Occurrence
Morning
Afternoon
Evening
Night
Potentially Affected Groups
Residents
Workers
Schools
Hospitals
Other
Mitigation Measures Observed
Other Observations / Findings
Recommendations