• Document No.

  • Conducted on

  • Prepared by;

  • Please state

  • Select date


  • Location
  • Town

  • Site classification

  • Site Name

Water Body

  • Pond type

  • Please state

  • Where on site - name/location?

  • Signage

  • Where & type

  • Is signage/extra signage needed?

  • Please state type & location

  • Is this replacing missing signage or new?

Photo of pond & surrounds

  • Photo

Water Surrounds

Looking North

  • Slope

  • Vegetation

Looking East

  • Slope

  • Vegetation

Looking South

  • Slope

  • Vegetation

Looking West

  • Slope

  • Vegetation


  • Fencing?

  • What percentage is fenced?

  • Type of fencing

  • Please state

  • Proximity of paths/access

  • Visibility of water body

  • Lighting

  • Amount of natural light

  • Activities involving water body

  • Please state

  • Litter present?

  • Please state:

  • Water Quality

  • Any signs of pollution?

  • Please state:

  • No other defects found at time of inspection

  • Please specify defects and action required:

  • Any other comments?

  • Please state:


  • Signature

  • Date & Time

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