Customer information

Customer name

Customer reference / merit number

Customer phone number

Customer email

Description of request / damaged asset

Tree location and details

Tree identification number / location

Tree species

Tree health

Tree structure

Useful life expectancy

Retention value

Comments on tree (is the species known for invasive roots)

Risk analysis

Details of investigation (visual only or other methods used)

Is the damage with in the trees structural root zone

What is the proximity of the trunk to the damaged asset

What evidence of damage has been observed

Other evidence of damage

Photos of damage
Site map
What other factors may be contributing to the damage

Comments on damage

Tree History

Previous merit inspections and works programmed

Proposed mitigation
Remedial works

Root barrier dimensions if programmed

Timeframe for works



Signature of assessor
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.