Form for Dam Safety Inspection Report - DWA Home Page

Lêer Nr.: _____________________________________
DW 000 A
(Junie 2012)
VORM VIR DIE AANSOEK OM UITSTEL VIR DIE INDIENING VAN ’N
DAMVEILIGHEIDSEVALUERING (INSPEKSIE)VERSLAG
Naam van dam: _________________________________________________________________________________
Departementele lêer verwysingsnommer vir dam: ________________________________________________________
Nota: (i) Die vorm is vir die aansoek om uitstel vir die indiening van die formele evaluering (inspeksie) wat
elke 5 jaar deur ’n goedgekeurde professionele persoon gedoen moet word en is gebaseer om die
voorlegging van ’n interim inspeksie van die dam deur die eienaar of iemand deur hom aangestel.
(ii) Foto’s wat tydens die (evaluasie) inspeksie van die dam (stroomopkant, kruin en stroomafkant) en die
oorloop geneem is, moet aangeheg word, en daar behoort in die verslag na die foto’s verwys te word.
(iii) Daar word aanbeveel dat bome en bosse wat die interim inspeksie sal belemmer voor die evaluasie
(inspeksie) verwyder moet word in ooreenstemming met die bedryf en Instandhoudingshandleiding
van die dam.
AFDELING 1: KONTAKBESONDERHEDE
Naam van Eienaar / Persoon in Beheer_________________________________________________________________
Posadres_________________________________________________________________________________________
_________________________________________________________________________Poskode________________
Tel Nr.__________________________________________________________________________________________
E-Pos Adres______________________________________________________________________________________
AFDELING 2: INTERIM INSPEKSIE VAN DIE DAM
Datum: ______________________________________ Watervlak in dam: _____________________________
Het dit onlangs gereën? ____________________________ Beskryf: _____________________________________
Persone teenwoordig tydens inspeksie: ________________________________________________________________
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GRONDWALLE
KRUIN VAN GRONDWALLE
Kruinwydte (m) _______________ Is die kruinwydte nog soos gebou? ______________________________________
Is die kruin nog orals ewe hoog, of het dit versak? _______________________________________________________

2
Is daar tekens van erosie? __________________ Beskryf: _____________________________________________
________________________________________________________________________________________________
Is daar tekens van krake? ___________________ Beskryf (gebruik aparte vel indien nodig) ___________________
Het die kruin instandhouding nodig? _________________________________________________________________
Is daar tekens van gate (miere, rotte, meerkatte, molle ens.) _______ Beskryf: ______________________________
STROOMOPHELLING VAN GRONDWALLE
Helling (vertikaal: horisontaal): _____________________________________________________________________
Hellingbeskermingsmaatreëls (indien enige): ___________________________________________________________
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Is daar tekens van erosie? _______________________ Beskryf: _____________________________________
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Is daar tekens van krake? ________________________ Beskryf: _____________________________________
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Is daar tekens van versakking? ____________________ Beskryf: _____________________________________
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STROOMAFHELLING VAN GRONDWALLE
Helling (vertikaal: horisontaal): ____________________________________________________________________
Hellingsbeskermingsmaatreëls (indien enige): __________________________________________________________
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Is daar enige tekens van erosie? ___________________ Beskryf: _____________________________________
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Is daar enige tekens van krake? _____________________ Beskryf: _____________________________________
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Is daar tekens van versakking? _____________________ Beskryf: _____________________________________
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Is daar tekens van uitbulting of afskuiwing? ____________________________________________________________
Is daar nat kolle? _____________________________ Beskryf: _____________________________________
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Is daar tekens van deursyferings/lekkasies? ___________ Beskryf: _____________________________________
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Hoeveelheid lekkasie? _____________________________________________________________________________

3
Is die lekwater troebel of skoon? _____________________________________________________________________
Is daar tekens van gate (miere, rotte, meerkatte, molle krappe, ens. ) ______ Beskryf: _______________________
PLANTEGROEI OP GRONDWALLE
Is daar enige bome of struike op die wal? ______________________________________________________________
Indien wel, beskryf tipe, grootte, aantal, posisie: ________________________________________________________
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DREINERINGSTELSEL VAN GRONDWALLE
Is ‘n toondrein of interne dreineringstelsel voorsien? ____________________________________________________
Beskryf: _______________________________________________________________________________________
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Hoeveelheid lekkasie? _____________________________________________________________________________
Is die lekwater daaruit troebel/skoon? ________________________________________________________________
BETONWALLE
Kom krake voor? _________ Beskryf op aparte vel indien nodig (posisie, grootte, lengte): _________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Is daar lekkasies op krake? _____________ Beskryf (vloeitempo): _________________________________
_______________________________________________________________________________________________
Is daar lekkasies op die lasse? ___________________ Beskryf: _____________________________________
_______________________________________________________________________________________________
Is daar versakking? ____________________________ Beskryf: _____________________________________
Is daar relatiewe beweging? ______________________ Beskryf: _____________________________________
_______________________________________________________________________________________________
Beskryf toestand van beton: ________________________________________________________________________
_______________________________________________________________________________________________
Stroomophelling (horisontaal: vertikaal): _____________________________________________________________
Stroomafhelling (horisontaal: vertikaal): ______________________________________________________________
Beskryf drukverligtingsgate: _______________________________________________________________________
_______________________________________________________________________________________________
STROOMAFTOON EN STROOMAFFLANKE VAN ENIGE DAM
Beskryf nat kolle (posisie, omvang): _________________________________________________________________
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4
Beskryf deursyferings/lekkasies (posisie, vloeitempo): ___________________________________________________
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Is die lekwater troebel/skoon? _______________________________________________________________________
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Is daar bome of struike binne 5 meter van die wal af? ____________________________________________________
Beskryf: ________________________________________________________________________________________
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VLOEDUITLATE (VAN ENIGE DAM)
Toestand van strukture in uitloopkanaal (drumpelmure, keermure, ens.) ______________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
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Word stabiliteit van damwal deur uitloopkanaal bedreig? _________________________________________________
Is daar los materiaal in oorloopkanaal? _______________ Beskryf: ______________________________________
Is daar erosie in oorloopkanaal? _____________________ Beskryf: ______________________________________
Is daar erosie in rivier? ___________________________ Beskryf: ______________________________________
Stem oorloopwydte en totale vryboord ooreen met planafmetings? __________________________________________
UITLAATWERKE (VAN ENIGE DAM)
Aantal uitlaatpype: ____________ Diameter: _________________ Tipe: _________________________________
Fondamenttoestande van uitlaatpyp: __________________________________________________________________
Is die beheerpunt stroom op en stroom af: _____________________________________________________________
Is daar voorsiening vir ‘n noodklep stroomop? __________________________________________________________
Word die kleppe gereeld geoefen? ___________________________________________________________________
Is die kleppe in ‘n werkende toestand? ________________________________________________________________
Lekkasies langs die uitlaatpyp? ______________________________________________________________________
Erosie stroom af? _________________________________________________________________________________
Roesbeskerming? _________________________________________________________________________________
Ander waarnemings: ______________________________________________________________________________
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AFDELING 5: INTERIM AANBEVELINGS
5
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AFDELING 3: AANSOEK OM UITSTEL
Motivering vir uitstel_______________________________________________________________________________
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6
HANDTEKENING: _________________________________________ DATUM: ______________________
Onthou om die foto’s van die dam en die oorloop aan te heg.