Operation And Maintenance Plan Template Page 29
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39Dam ID: HI-####
Inspection No:
Hawaii Reservoir
Date:
Month Day, Year
D
S
I
S
AM
AFETY
NSPECTION
HEET
Inspection Type:
Visual Dam Safety Inspection
Persons Present
Affiliation
Phone Number
Weather Condition:
Rain previous day
Rainy
Drizzle / Mist
Cloudy/Overcast
Partly Cloudy Sunny
Dry
Comments:
1. General: (Information currently on file, update as required)
Dam/Res. Name
Owner
Owner Contact
Owner Ph.
Lessee
Lessee Ph.
O & M Contractor
O & M Ph.
(decimal)
Nearest City
Latitude
(decimal)
County
Longitude
Tax Map Key(s)
Dam Status
Hazard Potential
Dam Size
Year Completed
Dam Length
ft. Dam Height
ft.
Normal Storage
ac. ft. Max. Storage
ac. ft. Max. Surface Area
ac.
Offsite Drainage Area
sq mi. Spillway Type
Max. Spillway Q
cfs
Owner owns land under dam facility:
Emergency Action Plan on file with the Department:
Reports on file with the Department:
Sheet 1 of 11
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