d a m i n s p e c t i o n c h e c k l i s t（这是一件很重要的事，所以我也不知道。）.docVIP

DAM INSPECTION CHECKLIST Department of Environmental Protection Bureau of Waterways Engineering Division of Dam Safety NAME OF DAM: _______________________________ DEP DAM NO.: D____-______ LOCATION: Municipality: _______________________ County: __________________ DEP CLASSIFICATION DATA: Size: Hazard: PHYSICAL DATA: Type of Dam: ____________ Height of Dam: _______________ Normal Pool Storage Capacity: ________ ELEVATIONS: Normal Pool: Pool at Inspection: Tailwater at Inspection: DAM OWNER: _______________________ OPERATOR: ________________________ ADDRESS: ____________________________ _____________________________ PHONE: (___)-___-____ FAX NO.: (___)-___-____ E-MAIL ADDRESS: _______________________ A completed and signed Dam Owners Notice Checklist is to accompany this Inspection Checklist. PERSONS PRESENT AT INSPECTION: Name Title/Position Representing ______________________ _______________________ ______________________ ______________________ _______________________ ______________________ ______________________ _______________________ ______________________ ______________________ _______________________ ______________________ DATE OF INSPECTION: ____/______/______ WEATHER: _________________ TEMPERATURE: _________________ This is to certify that the above dam has been inspected and the following are the results of this inspection. Signature of Registered Professional Engineer Date (P.E. Seal Required) NAME OF DAM: DEP DAM NO.: DATE: ITEM CONDITION COMMENTS MONITOR IVESTIGATE REPAIR EMBANKMENT: CREST 1 Surface Cracking 2 Sinkhole, Animal Burrow 3 Low Area(s) 4 Horizontal Alignment 5 Ruts and/or Puddles 6 Vegetation Condition 7 Warning Signs 8 9 Additional Comments (Refer to item number if applicable): EMBANKMENT: UPSTREAM FACE 10 Slide, Slough, Scarp 11 Slope Protection 12 Sinkhole, Animal Burrow