SWMF Inspection Form v2.0.1

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Facility Information

Facility/subdivision name Facility number Facility type

Surrounding vegetation (pond buffer) Forested Shrubs Meadow Maintained grass

Inspection Information

Inspector name(s) Date of inspection Time of inspection Weather when inspected

Outfalls

Dense vegetation 0 1 2 3 N/I N/A

Outfall function 0 1 2 3 N/I N/A

Manholes, frames, covers 0 1 2 3 N/I N/A

Undercutting outlet 0 1 2 3 N/I N/A

Erosion 0 1 2 3 N/I N/A

Displaced rip-rap 0 1 2 3 N/I N/A

Sediment deposits 0 1 2 3 N/I N/A

Outfall obstructed 0 1 2 3 N/I N/A

Trash rack obstructed 0 1 2 3 N/I N/A

Trash rack corrosion 0 1 2 3 N/I N/A

Principal Spillway

Minor spalling (<3cm) 0 1 2 3 N/I N/A

Major spalling (exposed rebar) 0 1 2 3 N/I N/A

Joint failure 0 1 2 3 N/I N/A

Loss of joint material 0 1 2 3 N/I N/A

Leaking 0 1 2 3 N/I N/A

Corrosion 0 1 2 3 N/I N/A

Deficient protection 0 1 2 3 N/I N/A

Misalignment or split seams/joints 0 1 2 3 N/I N/A

Emergency Spillway

Vegetation growth or unauthorized plantings 0 1 2 3 N/I N/A

Erosion or back cutting 0 1 2 3 N/I N/A

Soft or boggy areas 0 1 2 3 N/I N/A

Obstruction/debris 0 1 2 3 N/I N/A

Permanent Pool (normal water line for wet pond)

Visible pollution 0 1 2 3 N/I N/A

Shoreline and/or side slope erosion 0 1 2 3 N/I N/A

Aquatic bench inadequately vegetated 0 1 2 3 N/I N/A

Abnormally high or low water levels 0 1 2 3 N/I N/A