Title Page

  • Inspection Date

  • Inspected By

  • Location
  • Line No. and Chainage

Culvert Details

  • Culvert Type

  • Diameter (m)

  • Width (m)

  • Height (m)

  • Details

  • Culvert Material

  • Is the Culvert Re-lined or Re-sleeved

  • Liner or Sleeve material

  • Approximate Culvert Length (~m)

  • No. of Barrels

  • Visible Skew

  • Skew Direction

  • Flow Direction

Site Access

  • Distance to Access road / Maintenance Track (~m)

  • Height of Embankment above obvert of culvert

  • Surrounding environment conditions (1= Non-aggressive - 5= Most aggressive)

  • Are there any external requirements for access (ie. rail permits)

  • Requirements

  • General Comments

  • Site Access Photos

Culvert Condition

  • Severity Level Rating Descriptions

  • 1= The item is in critical, imminent failure condition and requires immediate attention. Major
    deterioration or section loss present in primary structural components affecting structural stability.

  • 2= The item is in poor condition and requires attention in the next financial year. Without repairs there
    is potential for failure leading to a critical situation. Advanced section loss, deterioration, significant
    spalling or scour have affected primary structural components. Considerable settlement or
    misalignment.

  • 3= The item is in fair condition but requires attention before the next inspection. All primary structural
    components are functional and fit for purpose but may have minor section loss, cracking, spalling
    or scour. Moderate deterioration or disintegration and minor settlement or misalignment.

  • 4= The item is in good condition. No noteworthy deficiencies that affect the condition of the culvert.
    Insignificant damage and defects only with negligible misalignment. No work required.

  • 5= The item is in excellent condition. No deficiencies.

  • Overall Condition State

  • Monitoring Required

  • General Comments

  • Condition Photos

Inspection Findings

Waterways,Vegetation, debris, embankment erosion, scour, silt build-up, blockages, damaged guide-banks, revetment mattresses, rock protection

Scour

  • Severity Level

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Flow

  • Severity Level

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Walls and aprons - Headwalls, wing walls, aprons: material defects, impact damage, coatings, movement/settlement

Head LHS

  • Construction Material

  • Defects (Select all that apply)

  • Details

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Head Wing LHS

  • Construction Material

  • Defects (Select all that apply)

  • Details

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Apron LHS

  • Construction Material

  • Defects (Select all that apply)

  • Details

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Head RHS

  • Construction Material

  • Defects (Select all that apply)

  • Details

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Wing RHS

  • Construction Material

  • Defects (Select all that apply)

  • Details

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Apron RHS

  • Construction Material

  • Defects (Select all that apply)

  • Details

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Culvert Units

    Barrel
  • Severity Level

  • General Comments

  • Photos

  • Management Required

  • Routine Maintenance (Refer to Works codes table for definitions)(Select all that apply)

  • Specific maintenance (Refer to Works codes table for definitions)(Select all that apply)

Inspection Completion

  • Inspection Task Time

  • Have Issues been identified that require further investigation?

  • Details

  • Completed

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