Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Last Inspection conducted

  • Prepared by

  • Location
  • Inspection party

  • Add member
  • Name

  • Position

  • Company

Operational Status at time of inspection

  • Dam Details

    title.png
  • Consequence Category

  • Storage Level Gauge board (m), FSL=23.88

  • Storage Level mAHD, FSL = 364.27

  • Water in Storage ML, capacity at FSL = 3,150

  • release via spillway

  • Other Comments

  • Photos

  • Sketch

Conditions at time of inspection

  • Weather

  • Estimated Max Temperature degrees celsius

  • Sky

  • Wind

  • Rain

  • Days since last rain

  • Other Comments

  • Photos

  • Sketch

Dam Safety Management

  • O&M Manual on Site

  • O&M Manual Reviewed

  • Dam Safety Emergency Plan on Site

  • Dam Safety Emergency Plan reviewed

  • Drawings on site

  • Operator Knowledge

  • Operator training

  • Other Comments

  • Photos

  • Sketches

Crest

  • Guard fence

  • Concrete cracking

  • Concrete spalling

  • Concrete deterioration

  • Other observations

  • Photos

  • Sketch

Downstream Face

  • Concrete cracking

  • Concrete spalling

  • Concrete deterioration

  • Seepage on face

  • Seepage at toe

  • Toe protection

  • Other comments

  • Photos

  • Sketch

Upstream Face

  • Concrete cracking

  • Concrete spalling

  • Concrete deterioration

  • Photos

  • Other observations

  • Sketch

Abutments

  • Seepage

  • Cracks

  • Slides

  • Vegetation

  • Take any photos of abutment observations

  • Other deficiencies/comments for abutments

  • Sketch

Area Downstream of Dam

  • Seepage

  • Subsidence

  • Bulges

  • Vegetation

  • Comments

  • Photos

  • Sketch

Spillway

  • Crest

  • Training walls

  • Channel floor

  • Baffle blocks

  • Erosion

  • Underdrains

  • Seepage

  • Other comments

  • Photos

  • Sketch

Outlet works (upstream of tunnel plug)

  • Valve house

  • Screens

  • Offtake valves

  • Outlet pipe

  • Operating rods

  • Operating equipment

  • Security

  • Other comments

  • Photos

  • Sketch

Outlet tunnel

  • Rock stability

  • Pipework

  • Valves

  • Seepage

  • Lighting

  • Tunnel plug

  • Security

  • Other comments

  • Photos

  • Sketch

Outlet Works Operation

  • Valve Schematic

    Valve schematic.png
  • Top valve BL1 status

  • Top valve BL1 tested

  • Top valve BL1 last tested

  • Top valve BL1 test satisfactory

  • Other comments

  • Photos

  • Middle valve BL2 status

  • Middle valve BL2 tested

  • Middle valve BL2 last tested

  • Middle valve BL2 test satisfactory

  • Other comments

  • Photos

  • Lower valve BL3 status

  • Lower valve BL3 tested

  • Lower valve BL3 last tested

  • Lower valve BL3 test satisfactory

  • Other comments

  • Photos

  • Valves BL4 and BL5 downstream of bifurcation in the tunnel

  • Other comments

  • Photos

  • LHS Isolating valve downstream of portal BL6 status

  • LHS Isolating valve downstream of portal BL6 tested

  • LHS Isolating valve downstream of portal BL6 last tested

  • LHS Isolating valve downstream of portal BL6 test satisfactory

  • Comments

  • Photos

  • RHS Isolating valve downstream of portal BL7 status

  • RHS Isolating valve downstream of portal BL7 tested

  • RHS Isolating valve downstream of portal BL7 last tested

  • RHS Isolating valve downstream of portal BL7 test satisfactory

  • Comments

  • Photos

  • Overall comments

  • Overall photos

Inlet Works

Bundaleer Weir

  • Crest

  • Downstream face

  • Upstream face

  • Abutment blocks

  • Area downstream

  • Outlet gates

  • Outlet screen

  • Scour valve

  • Bundaleer channel

  • Bundaleer aqueduct

  • Comments

  • Photos

Freshwater creek Weir

  • Crest

  • Downstream face

  • Upstream face

  • Abutment blocks

  • Outlet works

  • Channel

  • Comments

  • Photos

Broughton Weir

  • Crest

  • Downstream face

  • Upstream face

  • Abutment blocks

  • Outlet works

  • Channel

  • Scour Valve

  • Comments

  • Photos

  • Other comments

  • Photos

  • Sketch

Access to Dam

  • Right Abutment

  • Left abutment

  • Other access to dam notes

  • Access to dam photos

  • Sketch

Reservoir

  • Landslips around rim

  • Boat Ramp

  • Other comments

  • Sketch

  • Photos

Communications

  • Telemetry

  • Telephones

  • Radios

  • Other comments

  • Sketch

  • Photos

Power Supply

  • Normal

  • Standby

  • Other comments

  • Sketch

  • Photos

Instrumentation

  • Survey marks

  • Survey pillars

  • Pneumatic piezometers

  • Concrete thermometers

  • Inverted pendulum

  • Tunnel seepage

  • Other comments

  • Photos

  • Sketch

Surveillance

  • Consequence Category

  • Rainfall

  • Rainfall observation frequency meets ANCOLD guidelines

  • Storage Level

  • Storage Level Observation frequency meets ANCOLD guidelines

  • Seepage

  • Seepage Observation frequency meets ANCOLD guidelines

  • Seepage Analysis

  • Seepage Analysis observation frequency meets ANCOLD guidelines

  • Pore Water Pressure

  • Pore water pressure observation frequency meets ANCOLD guidelines

  • Surface Displacement

  • Surface Displacement observation frequency meets ANCOLD guidelines

  • Internal displacement

  • Internal displacement observation frequency meets ANCOLD guidelines

  • Seismological

  • Seismological observation frequency meets ANCOLD guidelines

  • Telemetry

  • Telemetry observation frequency meets ANCOLD guidelines

  • Visual Inspections

  • Visual Inspection observation frequency meets ANCOLD guidelines

  • Other comments

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.