Caleb Ward over at Premium Beat.com recently posted a "Location Fact Sheet" template. I was interested as I will probably not have an LM on my next couple of projects; also, as a working 1st/2nd/3rd A.D. I would ask or wish to know the answers to a lot of the same questions as an LM/ALM.
Caleb's sheet, while purty (real purty) was not to my taste - too much empty space, used light colouring for the bounding boxes and some copy (a big no-no for photocopying of photocopies) and simply did not ask enough questions.
I've put my money where my mouth is and drafted my own version, available on Scribd, below.