Major Culvert Inspection

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Major Culvert #

• Select date

  Date

• Photo 1 - Upstream Face

  Media

• Photo 2 - Downstream Face

  Media

• Photo 3 - Approach From North/West

  Media

• Photo 4 - Approach From South/East

  Media

ROADWAY

• Are any signs missing, damaged or obscured

  Safe

  At Risk

  N/A

• Is the ID marker missing, damaged or obscured

  Safe

  At Risk

  N/A

• Is there any damage to guardrail including end terminals<br>

  Safe

  At Risk

  N/A

• Is there any damage to delineators

  Safe

  At Risk

  N/A

• Is the road side drainage outfall to waterway blocked, scoured or eroded

  Safe

  At Risk

  N/A

• Have the road approaches settled or depressed

  Safe

  At Risk

  N/A

• Have the road approaches got visible crocodile cracking or potholes

  Safe

  At Risk

  N/A

STRUCTURE

ENDWALLS

• Is there cracking evident on endwalls

  Safe

  At Risk

  N/A

• Is there exposed reinforcement on end walls

  Safe

  At Risk

  N/A

• Is there separation between culvert and endwalls

  Safe

  At Risk

  N/A

• Is there erosion and scour evident around the end walls

  Safe

  At Risk

  N/A

CULVERT

• Is there cracking evident on segments

  Safe

  At Risk

  N/A

• Is there exposed reinforcement on segments

  Safe

  At Risk

  N/A

• Is there separation between segments

  Safe

  At Risk

  N/A

• Is there shape deformation of the segments

  Safe

  At Risk

  N/A

WATERWAY

• Is there debris built up on upstream side of structure

  Safe

  At Risk

  N/A

• Is there erosion and scour evident in the waterway bed

  Safe

  At Risk

  N/A

• Is there erosion and scour evident in waterway embankment

  Safe

  At Risk

  N/A

• Is there vegetation causing damage to structure or obstructing the waterway

  Safe

  At Risk

  N/A

Inspection Team Summary

• General Notes

• Is a further level 2 inspection required

  Safe

  At Risk

  N/A

• Add signature

  Sign