Bioretention Inspection Form (Page 2 of 4) in pdf

Bioretention Inspection Form Page 2

Based on visual assessment of the site, answer the following questions and take

photographs of the site:

Facility Footprint

1. Are there indications of any of the following in the bioretention facility? (If yes, mark

on site sketch)

☐ Erosion

☐ Settlement

☐ Seeps and wet spots

☐ Rodent holes or water piping

☐ Trash and debris

☐ Leaves

☐ Other: _____________

☐ None

2. Is there ponded water in the bioretention facility? ☐ Yes ☐ No

If yes, describe the potential reasons for ponded water below (leaf or debris build up,

non-functional underdrain, groundwater input, illicit connection, inadequate capacity

in facility, etc.)

Notes

Inlets/Outlets/Pipes

3. How many inlet structures are present? ☐ 0 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5 ☐ > 5

Are any of the inlet structures clogged? (If yes, mark the location on your site sketch

and fill in the boxes below with the cause of the clogging (e.g., debris, sediment,

vegetation, etc.) ☐ No ☐ Partially ☐ Completely ☐ NA

4. Are any of the inlet structures altered from the original design or otherwise in need of

maintenance? (If yes, write in reason: frost heave, vandalism, unknown, etc.)

Inlet #:

Partially clogged

Completely clogged

Reason for maintenance

Bioretention Inspection Form Page 2