HSWAGATA BUDDHA TOOTH RELICS PRESERVATION MUSEUM
RELIC INTAKE CONDITION ASSESSMENT FORM
Form Code: HSW-F05
Relic ID Code: ____________________________
Date of Assessment: ____ / ____ / ______
Assessor Name: ____________________________
Department: _______________________________
1. OVERALL CONDITION (tick one)
[ ] Excellent [ ] Good [ ] Fair [ ] Poor
2. CONDITION DETAILS
2.1 Visible Damage (cracks, chips, stains, etc.):
__________________________________________
__________________________________________
2.2 Previous Repairs or Alterations (if visible or known):
__________________________________________
__________________________________________
2.3 Signs of Biological Risk (mould, pests, etc.):
__________________________________________
2.4 Structural Stability (stable / fragile / very fragile):
__________________________________________
3. ENVIRONMENTAL CONTEXT AT INTAKE
3.1 Temperature (if measured): ______ °C
3.2 Relative Humidity (if measured): ______ %
3.3 Lighting at Time of Examination:
__________________________________________
4. RISK ASSESSMENT
4.1 Immediate Risks to the Relic:
__________________________________________
4.2 Recommended Risk Level:
[ ] Low [ ] Medium [ ] High
5. RECOMMENDED ACTIONS
(tick and describe)
[ ] Special storage needed:
__________________________________________
[ ] Cleaning / conservation needed:
__________________________________________
[ ] Scientific testing suggested:
__________________________________________
[ ] No immediate action needed.
[ ] Other:
__________________________________________
Assessor Signature: _________________________ Date: ____/____/____
Approved By (Conservation Head): _____________ Date: ____/____/____
