Form A - Fish Passage - Culvert Inspection - Side 1
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Date (mm/dd/yy) |
Stream Name |
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Road Name/ID# |
Road Location (MoF district) |
100 Mile House |
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UTM/GPS Location |
Road Responsibility |
Weldwood |
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1:20 000 Map Sheet |
Watershed Code |
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Site Number |
Recorders Name |
TA |
Culvert Characteristics
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Culvert Diameter (mm) |
FPC Diameter Estimate (mm) |
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Culvert Length (m) |
Culvert Slope (%) |
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Culvert Material |
High Water Mark (cm) |
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Culvert Water Velocity (m/s) |
Current Culvert Water Depth (cm) |
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Culvert Shape |
Culvert Outfall Drop (cm) |
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Culvert Wetted Width (cm) |
Culvert Maintenance |
Hi / Mod / L / No |
Stream Characteristics
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Stream Reach |
Stream Classification |
S1 S2 S3 S4 S5 S6 P |
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Sediment Source/Degree |
Yes / No - Hi / Mod / L |
Blue Listed/ Significant |
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Pool Depth at Outfall (cm) |
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Measure |
Measurement(s) Above Culvert |
Measurement(s) Below Culvert |
Average Measurement |
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Mean Wetted Width (m) |
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Mean Bankfull Width (m) |
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Mean Water Depth (cm) |
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Mean Bankfull Depth (cm) |
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Stream Water Velocity (m/s) |
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Stream Gradient (%) |
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Fish Presence |
Yes / No / No Survey |
Yes / No / No Survey |
NA |
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Fish Sampling Method |
NA |
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Sampling Effort (time) |
NA |
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Species Present |
NA |
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Beaver Activity/Type |
NA |
Barrier Evaluation:
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Barrier |
Full Partial None Undetermined |
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Barrier Type
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Prescription
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Form A - Fish Passage - Culvert Inspection - Side 2
Comments:
Site Photos: Roll # Inlet upstream photo # Inlet downstream photo #
Outlet upstream photo # Outlet downstream photo #
Other photos
Form B - FPCI Summary Table
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Priority Rank |
Score |
Site Number |
Barrier |
Stream Length Gained |
X - Reference Site Number(s) |
Prescription |
Form C - Other Priority Culvert Crossings Summary
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Priority Rating |
Site Number |
Maintenance Issues |
Sediment Source |
Prescription |