Title Page

  • Date and Time:

  • Inpsector:

  • Property Location:
  • Request Number:

  • Property Details:

  • Address of property
  • Owner of property
  • Phone Number

  • Nature Of Request/Complaint:

  • Location Of Tree:

  • Comments:

  • Tree Details:

  • Botanical Name:

  • Common Name:

  • Tree Height:

  • Tree Spread:

  • D.B.H.

  • Age:

  • Soil Condition:

  • U.L.E

  • Landscape Value:

  • Works History:

  • Tree Adjacent to:

  • Adjacent to Distance:

  • Powerlines:

  • Tree Pictures

  • Comments:

  • Tree Condition Assessment:

  • Structure:

  • Crown:

  • Trunk:

  • Vigour:

  • Roots:

  • Pests:

  • Diseases:

  • Habitat Potential:

  • Rarity:

  • Potential Seed Source:

  • Significance

  • Comments:

  • Trees with a total score greater than 25 do not qualify for removal.
    Trees with a total score less than 25 will only be considered for removal if no other option is viable.

  • Possible Effects on Infrastructure:

  • Buildings:

  • Drains and Pipes

  • Roadways and Footpaths:

  • Other Infrastructure:"

  • Recommended Actions:

  • What Action is Required

  • Action Timeframe:

  • Stump Removal Required:

  • Works Description:

  • Add signature

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