CULVERT CONDITION Inspection Type

Routine
INSPECTION Detailed

Structure Structure Inspection Date

Number Name (yyyy/mm/dd)

COMPONENT PERCENT CONDITION RATING INSPECTION NOTES BY COMPONENT

Enter % in each condition. All poor or very poor conditions must be expired.
See BMIS User Manual 15.2.3 Label explanation(s) with component numbers.

CHANNEL AND
EMBANKMENT E G F P V X N
1 Debris Risk
2 Stream Bank/Bed Scour
3 Trash Rack
4 Inlet Conditions
5 Outlet Conditions
6 Flow Capacity
7 Roadway over Culvert

STRUCTURE

8 Wing Walls
9 Head Wall
10 Cut-off Wall
11 Roof
12 Sidewalls
13 Floor
14 Foundation
15 Fisheries Features
16 Joints
17 Bolts

General Inspection Notes:

Urgency Rating Notes:

Condition Codes Urgency Rating

E Excellent V Very Poor
G Good X Not Inspected
F Fair N Not Applicable
P Poor For definition, see
For Condition Guidelines see BMIS User Manual
BMIS User Manual 15.2.2. 15.2.8. "4" and
"5" rating must be
explained.

Inspection (please type or print) Signature

Side 1 of 2
 Structure Number

Drainage Area Description (water level fluctuation, logging debris, etc.)

Rehab Work Notes

Maintenance Work Notes

Side 2 of 2