Drainage Structure Assessment Field Form
Date of Inspection
Inspector Name
Structure ID / No.
Location / Coordinates
Structure Type
Culvert
Pipe
Box
Channel
Other
Material
Concrete
Metal
Plastic
Masonry
Other
Dimensions
Condition Assessment
Inlet Condition
Good
Fair
Poor
Outlet Condition
Good
Fair
Poor
Barrel Condition
Good
Fair
Poor
Sediment/Debris Present
None
Minor
Significant
Vegetation Encroachment
None
Some
Severe
Erosion Present
No
Minor
Major
Notes & Recommendations
Notes
Recommendations
Photos/Sketches
List of Attached Files