Title Page

Inspection Information

  • Inspection day photo general

  • Name of Consultant

  • Dam ID

  • Project Number

  • Dam Name

Cateogory Assessment

  • Failure impact assessment category

  • Population at risk (PAR), latest

  • Consequence Assessment

Terminology definition

Condition Rating

  • Descripition - The follownig terminology is used in describing the structural condition of the facilities or the operational condition of the equipment

  • Satisfactory - Will fulfil intented purposes.

  • Fair - Will fulfil intented purposes; Maintenance is required.

  • Poor - May not fulfil intented purposes; Maintenace is needed.

  • Unsatisfactory - Will not fulfil intented purposes.

Other terminology

  • Description other - Other standard terminology is used as follows where the above terms are not valid:

  • None evident - No visual eviednece for conition

  • Not inspected - Diffcult to access confined spaces and/or asset/plant in operatoin or submerged. While impractical to access during annual inspections, these assets are inspected during five yearly inspections or when water levels allow.

  • Not operated - Plant Visibly inspected but not able to be tested. Typically these are large mechanical/electrical assets that require additional personnel on site to operate. While not operated for annual inspections these assets are operated during five yearly inspections or when water level allows.

General Information

General

  • Date of last inspection

  • Inspection Date

  • Inspection Team

  • Time of inspection

  • Report prepared by

  • Report reviewed by

  • Report approved by

  • General comments

Conditions at time of inspection

  • Weather

  • Latest rain

  • Temperature

  • Wind

Operational status at time of inspection

  • Reservoir water level

  • Water level photo

Releases

  • Death of spillway overtopping

  • Outlet releases

Embankment

Embankment

  • Embankment Type

Upstream face

  • General

  • Cracking

  • Slips/slides

  • Depressions

  • Budging

  • Erosions/scour

  • Beaching

  • Vegetative Growth

  • Animal Burrows

  • Ant/termite Workings

  • Notes

  • Photos

  • Recommendations

Crest

  • General

  • Cracking

  • Sinkholes

  • Alignment

  • Erosion/scour

  • Vegetative growth

  • Depressions

  • Settlement

  • Ant/termite workings

  • Notes

  • Photos

  • Recommendations

Downstream face

  • General

  • Cracking

  • Wet Spots

  • Slips/slides

  • Sinkholes

  • Depressions

  • Budging

  • Erosion/scour

  • Vegetative Growth

  • Animal Burrows

  • Ant/termite Workings

  • Notes

  • Photos

  • Recommendations

Downstream toe

  • General

  • Cracking

  • Wet Spots

  • Sinkholes

  • Depressions

  • Budging

  • Boils

  • Erosion/scour

  • Vegetative Growth

  • Animal Burrows

  • Ant/termite Workings

  • Notes

  • Photos

  • Recommendations

Left abutment

  • General

  • Cracking

  • Seepage

  • Erosion/scour

  • Vegetative Growth

  • Notes

  • Photos

  • Recommendations

Right abutment

  • General

  • Cracking

  • Seepage

  • Erosion/scour

  • Vegetative Growth

  • Notes

  • Photos

  • Recommendations

Spillway

Main spillway general

  • General

Main spillway inlet

  • General

  • Spillway Guard

  • Notes

  • Photos

  • Recommendations

Main spillway outlet

  • Structure

  • Structure Grate

  • Downstream Erosion/scour

  • Notes

  • Photos

  • Recommendations

Aux Spillway

  • General

  • Cracking

  • Slips/slides

  • Sinkholes

  • Depressions

  • Budging

  • Erosion/scour

  • Vegetative Growth

  • Animal Burrows

  • Ant/termite Workings

  • Notes

  • Photos

  • Recommendations

Main & auxilliary spillway outlet channel

  • Erosion/scour

  • Vegetative growth

  • Note

  • Photos

  • Recommendations

Instructmentation Reading

Field Condition of Instructmentation

  • Instructmentation general condition

Storage Level

Primary staff gauge

  • General

  • Note

  • Photos

  • Recommendations

Secondary staff gauge

  • General

  • Note

  • Photos

  • Recommendations

Standpipe piezometers

  • Time readings taken

BH3

  • General

  • 10m

  • 10 temp

  • 19m

  • 19 temp

  • Notes

  • Photos

  • Recommendations

BH4

  • General

  • 6.5m

  • 6.5 temp

  • 9.05m

  • 9.05 temp

  • 17.75m

  • 17.75 temp

  • Notes

  • Photos

  • Recommendations

Seepage downstream toe

  • General

  • Flows

  • Access

  • Notes

  • Photos

  • Recommendations

Facilities

Survey points

  • General

  • Notes

  • Photos

  • Recommendations

Public safety and security

  • General condition

  • Fencing

  • Signs

  • Notes

  • Photos

  • Recommendations

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.