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SEDIMENTATION POND INSPECTION FORM <br />Pond <br />Date of I <br />PDES No. Q? <br />EMBANKMENT <br />1. Adequacy of the vegetative cover: Excellent, <br />2. Erosion forming gullies: Extensive, <br />3. Is wave action causing erosion: <br />On [he upstream embankment? <br />A[ the principal spilhvay inlet? <br />4. Erosion of the downstrearn toe of the embankment? <br />The cause of the erosion is attributed to: <br />5. Is seepage occurring tluough the dam? <br />Could [his seepage cause potential instability? <br />PRINCIPAL SPILLWAY <br />1. Is the principal spillway system in working order? <br />2. Is the inlet free of debris and restrictive mmerial? <br />3. Is the discharge outlet free of restrictive material? <br />Moderate, Fet Poor <br />Some, erv F w, None <br />Yes No ~-- <br />Yes No_~ <br />Yes No (_ <br />Yes No r, <br />Yes No <br />Fes L No <br />Yes G- No <br />Y"es ~ No <br />~. Is erosion occurring at the discharge outlet? Yes No~_ <br />Evaluate [he severity: Extensive Moderate Just SC.trtin¢ None <br />EMERGENCY SPILLWAY <br />1. Is the overall emergency spillway system capable of passing design storm discharge? <br />Yes ~_ No <br />2. Does ~it appear as d dte emergenry spillway has discharged water since the last inspection'? <br />Yes No ~- <br />3. Is erosion occurring at any secuon of the emergency spilhvay? Y"es No~ <br />Describe the extent <br />SEDIMENT STORAGE CAPACITY <br />1. Has the design store capacity of the reservoir been surpassed? ~ Yes No_~~ <br />Please add any special comments concerning potentially dangernus problems on the back of this <br />sheet'. ~~(~,~(.t~,,,ft't~- <br />Inspected b.~: ~. <br />