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Item Status Notes <br />Outlet structure clear ❑ Yes ❑ No <br />Sediment accumulation ❑ None ❑ Moderate ❑ Excessive <br />Drainage functioning property ❑ Yes ❑ No <br />SECTION C -STRUCTURAL COMPONENTS <br />Item Condition Notes <br />Outlet structure ❑ Good ❑ Fair ❑ Poor <br />Embankments/slopes ❑ Stable ❑ Eroded <br />Riprap ❑ Good ❑ Displaced <br />Trash rack ❑ Functional ❑ Blocked <br />SECTION D -MAINTENANCE ACTIONS <br />Activity Completed Date <br />Mowing ❑ Yes ❑ No <br />Debris removal ❑ Yes ❑ No <br />Sediment removal ❑ Yes ❑ No <br />Repairs ❑ Yes ❑ No <br />SECTION E -PHOTOS REQUIRED <br />Attach photos of: <br />• Pond overview <br />• Inlet/outlet structures <br />• Any deficiencies <br />CERTIFICATION <br />I certify that this inspection is accurate and the facility is maintained in accordance with <br />City requirements. <br />Signature: Date: <br />