Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Last Inspection conducted

  • Prepared by

  • Location
  • Inspection party

  • Add member
  • Name

  • Position

  • Company

Operational Status at time of inspection

  • Dam details

    details.png
  • Consequence Category

  • Storage Level Gauge board (m), FSL=6.35m

  • Storage Level mAHD, FSL = 407.50 m

  • Water in Storage ML, capacity at FSL = 480ML

  • Releases via outlet ML/day

  • release via spillway

  • Other Comments

  • Photos

  • Sketch of deficincies

Conditions at time of inspection

  • Weather

  • Estimated Max Temperature degrees celsius

  • Sky

  • Wind

  • Rain

  • Days since last rain

  • Other Comments

  • Photos

  • Sketch

Dam Safety Management

  • O&M Manual on Site

  • O&M Manual Reviewed

  • Dam Safety Emergency Plan on Site

  • Dam Safety Emergency Plan reviewed

  • Drawings on site

  • Operator Knowledge

  • Operator training

  • Other Comments

  • Photos

  • Sketches

Crest

  • Cracks

  • Vegetation

  • Sink Holes

  • Subsidence

  • Overtopping

  • Wheel ruts

  • Other deficiencies/comments for the crest.

  • Take photos of any deficiencies found on crest

  • Sketch

Downstream Face

  • Cracks

  • Slips

  • Erosion

  • Vegetation

  • Animal Activity

  • Bulges

  • Subsidence

  • Seepage

  • Other deficiencies/comments for the downstream face

  • Take photos of any deficiencies found on downstream slope

  • Sketch

Upstream Face

  • Cracks

  • Slips

  • Erosion

  • Vegetation

  • Subsidence

  • Animal Activity

  • Bulges

  • Wave Effects

  • Rock Facing

  • Take photos of any deficiencies found on upstream face

  • Other deficiencies/comments for the upstream face

Abutments

  • Cracks

  • Slips

  • Erosion

  • Vegetation

  • Subsidence

  • Seepage

  • Take any photos of abutment observations

  • Other deficiencies/comments for abutments

  • Sketch

Area Downstream of Dam

  • Slips

  • Vegetation

  • Seepage

  • French drains

  • V notch weir

  • Drainage works from WFP

  • Comments

  • Photos

  • Sketch

Outlet Works

  • Concrete

  • Screen

  • Pipework

  • Valves

  • Valve chamber

  • Valve chamber access

  • Sump pump

  • Other comments

  • Photos

  • Sketch

Outlet Works Operation

Downstream 1219mm diameter valve

  • Valve Status

  • Valve tested

  • Valve last tested

  • Valve test satisfactory

  • Other comments

  • Photos

  • Sketch

Inlet works

  • Headwall

  • Screen

  • Concrete channel

  • Other comments

  • Photos

  • Sketch

Spillway

  • Concrete Apron

  • Training Walls

  • Excavated slopes

  • Erosion

  • Vegetation

  • Other comments

  • Photos

  • Sketch

Instrumentation

  • Survey Marks

  • Survey Pillars

  • Standpipes

  • Hydraulic piezometers

  • Gauge board

  • Other comments

  • Photos

  • Sketch

Access to Dam

  • Right Abutment

  • Left abutment

  • Access to dam photos

  • Other access to dam notes

  • Sketch

Reservoir

  • Landslips around rim

  • Boat Ramp

  • Other comments

  • Sketch

  • Photos

Communications

  • Telemetry

  • Telephones

  • Radios

  • Other comments

  • Sketch

  • Photos

Power Supply

  • Normal

  • Standby

  • Other comments

  • Sketch

  • Photos

Surveillance

  • Consequence Category

  • Rainfall

  • Rainfall observation frequency meets ANCOLD guidelines

  • Storage Level

  • Storage Level Observation frequency meets ANCOLD guidelines

  • Seepage

  • Seepage Observation frequency meets ANCOLD guidelines

  • Seepage Analysis

  • Seepage Analysis observation frequency meets ANCOLD guidelines

  • Pore Water Pressure

  • Pore water pressure observation frequency meets ANCOLD guidelines

  • Surface Displacement

  • Surface Displacement observation frequency meets ANCOLD guidelines

  • Internal displacement

  • Internal displacement observation frequency meets ANCOLD guidelines

  • Seismological

  • Seismological observation frequency meets ANCOLD guidelines

  • Telemetry

  • Telemetry observation frequency meets ANCOLD guidelines

  • Visual Inspections

  • Visual Inspection observation frequency meets ANCOLD guidelines

  • Other comments

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.