Floodgate visual Inspection Form

• Gate Number/Name

• Asset Number

• Scheme

  Select Foxton East drainage Himatangi drainage Hokio drainage Koputaroa drainage Makerua drainage Manawatu drainage Moutoa drainage Ohau-manakau Te kawau drainage Whirokino drainage LMS Eastern Northern

  • Foxton East drainage
  • Himatangi drainage
  • Hokio drainage
  • Koputaroa drainage
  • Makerua drainage
  • Manawatu drainage
  • Moutoa drainage
  • Ohau-manakau
  • Te kawau drainage
  • Whirokino drainage
  • LMS
  • Eastern
  • Northern

• Inspection date

  Date

• Inspected by

  Select Paul Arcus Emily Carrol Simon McPhail Paul Turner Geoff Gibson Jenna Buchanan Gary Jenkins Brent Whittingham

  • Paul Arcus
  • Emily Carrol
  • Simon McPhail
  • Paul Turner
  • Geoff Gibson
  • Jenna Buchanan
  • Gary Jenkins
  • Brent Whittingham
• Location
  Address

AMS

• Are details correct in AMS

  Yes

  No

  N/A

CCTV

• Has this culvert had a CCTV inspection carried out?

  Yes

  No

  N/A

• Date of last inspection

  Date

Structure details

• Type of gate

  Select Alloy Concrete Wooden Steel Plastic (torrent) Cast Iron Culvert only-No Floodgate MacEwans

  • Alloy
  • Concrete
  • Wooden
  • Steel
  • Plastic (torrent)
  • Cast Iron
  • Culvert only-No Floodgate
  • MacEwans

• Size/dimension of floodgate/outlet

• Amount of gate visible when inspected

Condition of structure

• Floodgate condition rating

  1

  2

  3

  4

  5

• Headwall inlet condition rating

  1

  2

  3

  4

  5

• Headwall outlet condition rating

  1

  2

  3

  4

  5

• Is there a winch?

  Off

  On

• Winch - Winch condition rating

  1

  2

  3

  4

  5

• Winch - Rope condition rating

  1

  2

  3

  4

  5

• Is there an inlet gate/stop log grooves?

  Off

  On

• Inlet gate/stop log groves condition rating

  1

  2

  3

  4

  5

• External visual CULVERT PIPE condition rating

  1

  2

  3

  4

  5

• Overall condition rating priority :

  1 scheduled

  2 medium

  3 high

  4 emergency

  5 emergency

Environmental

• Drain condition

  No work required

  Work required

• Access to floodgate

  No work required

  Work required

• Is there/should there be a marker post?

  Off

  On

• Correct numbering on marker post

  No work required

  Work required

• Is the marker post clearly visible?

  No work required

  Work required

• Marker post condition

  No work required

  Work required

Overall comments

• Best guess at remaining useful life

  less than 5 years

  5 - 10 years

  10 - 20 years

  20 - 50 years

• Any extra comments or work required

Photos

• Add media

  Media