Dam Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

DAM INFORMATION

• Asset ID

• Asset Location
  Address

• Reservoir Level

  Select Under Supply (water below inlet level) Full Supply (water level at inlet level) Over Supply (water level above inlet level) At Risk (water spilling over crest)

  • Under Supply (water below inlet level)
  • Full Supply (water level at inlet level)
  • Over Supply (water level above inlet level)
  • At Risk (water spilling over crest)

• Total Rainfall in the Past Week (mm)

  Select 0mm 1-5mm 5-10mm 10-20mm 20-50mm 50-100mm >100mm

  • 0mm
  • 1-5mm
  • 5-10mm
  • 10-20mm
  • 20-50mm
  • 50-100mm
  • >100mm

EMBANKMENT

• Upstream Face

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Crest

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Downstream Face

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Natural Surface (Toe Area)

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Reservoir Perimeter

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Intake Structure

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Upstream Headwalls

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Adjacent Upstream Embankment

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Downstream Headwalls

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Adjacent Downstream Embankment

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Gratings / Inlet & Outlet Grates

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Discharge Channels

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Auxiliary Outlet

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Other Structures & Features

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Energy Dissipators

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Erosion Protection

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Other Structural Features

  Select Good Condition Poor Condition - Requires Immediate Attention Not Applicable

  • Good Condition
  • Poor Condition - Requires Immediate Attention
  • Not Applicable

• Listed Defects

  Select Cracking Slip Deformation / Slump Erosion Vegetation Tree Growth Debris Changed Features Flow Obstructions Seepage Leakage Movement/Displacement Deterioration Other Damage Not Specified

  • Cracking
  • Slip
  • Deformation / Slump
  • Erosion
  • Vegetation
  • Tree Growth
  • Debris
  • Changed Features
  • Flow Obstructions
  • Seepage
  • Leakage
  • Movement/Displacement
  • Deterioration
  • Other Damage Not Specified

• Noted Changed Features

• Inspecting Officer Full Name

• Signature

  Sign

• Date & End Time

  Date