River Water Intake Screening Inspection Form
Complete this form to document your inspection of the river water intake site. Ensure all observations and actions are recorded accurately.
Site/Plant Name
*
Site/Plant ID or Reference
Inspection Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Inspector Full Name
*
First Name
Last Name
Intake Location Description
*
Weather Conditions
Please Select
Clear
Cloudy
Rainy
Stormy
Snowy
Foggy
Other
River Conditions
Please Select
Normal flow
High flow
Low flow
Flooded
Icy
Other
Intake Operating Status
*
Operating normally
Partially operating
Not operating
Other
Visual Condition of Intake Structure
*
Please Select
Good
Minor issues
Major issues
Needs repair
Debris, Sediment, or Algae Observed?
Debris present
Sediment present
Algae present
None observed
Other
Equipment Status
*
Please Select
All equipment functional
Minor faults
Major faults
Equipment out of service
Water Quality Screening Observations
Safety or Environmental Concerns Observed
Corrective Actions or Follow-Up Needed
General Comments
Submit Inspection
Should be Empty: