OPERATIONS AND MAINTENANCE INSPECTION RECORD

**(FLOODPLAIN EASEMENT-RECREATION)**

Project
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Inspection Date \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Structure Name
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Type \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Type of Inspection: Special \[ \] Structure Operation: Satisfactory \[
\]

Annual \[ \] Unsatisfactory \[ \]

> Formal \[ \]

Owner / Sponsor
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

  ------------- ------------ ------------------------ ------------ --------------
  Item          Condition\   Maintenance & Needed     Estimated\   Estimated
                S or U\*     Repairs                  Costs        Date\
                                                                   Repairs
                                                                   Completed

  1\.                                                              
  Vegetation                                                       

  2\.                                                              
  Floodplain\                                                      
  Easement                                                         

  3\.                                                              
  Recreation\                                                      
  Equipment                                                        

  4\.                                                              
  Recreation\                                                      
  Facilities                                                       

  5\. Safety                                                       
  ------------- ------------ ------------------------ ------------ --------------

\*S = Satisfactory, U = Unsatisfactory

Remarks:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

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Inspection team signatures:

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
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# O&M INSPECTION RECORD

**(FLOODPLAIN EASEMENT-RECREATION)**

**CHECKLIST**

The items to be checked at time of inspection may include, but are not
limited to the following: See O&M Manual Subpart F, Section 500.53 for a
more complete checklist.

1.  Vegetation

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a.  Need for cutting or spraying

b.  Need for reseeding

c.  Need for fertilizing

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2.  Buyout Area

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a.  No new development in buyout area

b.  Erosion by surface runoff

c.  Use of buyout area consistent with watershed plan

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3.  Recreation Equipment

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a.  Picnic Tables

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(1) All mechanical fasteners tight

(2) Surface coating/sealer intact

(3) No exposed sharp corners or edges

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b.  Benches

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(1) All mechanical fasteners tight

(2) Surface coating/sealer intact

(3) No exposed sharp corners or edges

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c.  Playground Equipment

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(1) All equipment functioning as designed

(2) All mechanical fasteners tight

(3) Surface coating/sealer intact

(4) No exposed sharp corners or edges

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d.  Playground Surface

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(1) Surface adequately covered and protected from erosion

(2) Area free of harmful debris (i.e., glass, nails)

(3) Surface area is reasonable level and free of standing water

(4) Surface functioning as designed

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4.  Recreation Facilities

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a.  Restrooms

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(1) Plumbing

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(a) Drains open

(b) Fixtures intact and functioning

(c) Valves and connections watertight and functional

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(2) Structure

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(a) Surface coating/sealer intact

(b) Roof

(c) Guttering and surface drainage

(d) Lighting

(e) Doors and latches

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(3) Cleanliness

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(a) Ventilation

(b) Sanitary

(c) Aesthetic appearance

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b.  Shelter/Pavilion

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(1) Structure

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(a) Surface coating/sealer intact

(b) Roof

(c) Guttering and surface drainage

(d) Lighting/Electrical

(e) Masonry

(f) Tables/Seating

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5.  Safety

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a.  Trash removal/collection

b.  Lighting

c.  Warning signage

d.  Parking Area/Access