City of Casey - Pre-Work Tree Root Inspection Form

• Conducted on

  Date

• Prepared by

• Location
  Address

Tree Condition

• Health

  Good

  Fair

  Poor

  Very Poor

• Structure

  Good

  Fair

  Poor

  Very Poor

• ULE

  1-5 years

  6-10 years

  10-20 years

  20+ years

• Trunk diameter at base (mm)

• Photo of tree(s) in contention:

  Media

Private Infrastructure

• Evidence of private infrastructure damage?

  Yes

  No

• Distance between damaged infrastructure and Council tree (m):

• Area of concern:

• Are there any Private trees within the vicinity of the damage infrastructure?

  Yes

  No

• Distance of Private Trees to damaged infrastructure (m):

• Are there any other potential explanations for the private infrastructure damage?

  Yes

  No

  Unable to determine

  Further Investigation Required

• Resident notified of outcome?

  Yes

  No

• Notification method?

  In Person

  Phone

  Email

  Mail drop

• Why Not?

• Footpath/Curb investigation required?

  Yes

  No

• Works required?

  Select No Root Investigation Root Pruning Root Barrier Installation

  • No
  • Root Investigation
  • Root Pruning
  • Root Barrier Installation

• Length and depth of channel dig(s) required:

• Marked photo of channel dig(s) required:

  Media
• Location
  Address