EditIncidentReport

Dam Safety Form for Reporting Dam Incidents

Fill in the following information. Leave blank if unknown or non-applicable.
Dam incidents include the following:

a. Dam Breach or Failure
b. Emergency Spillway Flow
c.Principal Spillway Damage of Malfunction
d. Seepage Problems
e. Embankment Damage or Signs of Distress ( Erosion, Cracks, Slides, Sinkholes, Settlements, or Bulges.)
f. Other Incidents or Conditions Affecting the Safety of a Dam (Activation of an emergency action plan, installation of an unapproved dam, unapproved modification of a dam, etc. )

Date Incident was Observed
Dam Name
County Where dam is Located
Legal Description of Dam Location (Section/township/Range) (if known)
General Description of Dam Location (if known)
Your First Name
Your Last Name
Your Address
Your City
Your State
Your Postal Code
Your Email address
Your Phone Number
First Name of Dam Owner(if you are not the dam owner)
Last Name of Dam Owner(if you are not the dam owner)
Have You Notified the Dam Owner(if you are not the dam owner)

Below are some categories and questions to help describe your dam incident. Please provide as much detail as possible. If none of the categories or questions suit your needs, simply describe your situation under "Other". A dam safety team member will contact you if additional information is necessary.

Reservoir Conditions
Please describe the rainfall amount and/or seismic event preceding the dam incident. Please indicate the reservoir level at the time of the dam incident. Please indicate if waves on the reservoir contributed to the dam incident. Indicate if the waves were due to wind, a seismic event, or a landslide in the reservoir area.

Dam Breach or Failure
How did the dam fail or breach? Is the breach partial or complete? Is there erosion damage to the embankment? (See Embankment Damage or Signs of Distress.) Was the principal spillway clogged with debris? (See Principal Spillway Damage or Malfunction .) Did the reservoir overtop the dam? (See Reservoir Conditions.) Did water flow through the emergency spillway? (See Emergency Spillway Flow.) Describe any damage caused by the breach flow or failure flow to anything downstream of the dam such as the channel, buildings, roads, railroads, or utility lines.

Emergency Spillway Flow
Include depth of flow in emergency spillway and duration of emergency spillway flow. In addition, describe any damage caused by the emergency spillway flow to the dam, reservoir, emergency spillway, or anything downstream of the dam such as the channel, buildings, roads, railroads, or utility lines. Was the principal spillway functioning properly? (If not, see Principal Spillway Damage or Malfunction.)

Principal Spillway Damage or Malfunction
If the spillway was damaged, please describe any damage to the spillway and the cause of the damage. What was the result of the damage? If the spillway malfunctioned, please describe the malfunction and the cause of the malfunction. What was the result of the malfunction? Did the dam breach or fail? (See Dam Breach or Failure.) Did water flow through the emergency spillway? (See Emergency Spillway Flow.) Did the reservoir overtop the dam? (See Reservoir Conditions.)

Seepage Problems
Please note the location of seepage. Is this a new area of seepage? About how many gallon per minute is flowing through the seep area. Is the water clear of muddy? Is the dam being damaged from the seepage? Is there a boil? Is the rate of the seepage flow increasing? Does the seepage threaten the dam?

Embankment Damage or Signs of Distress (These include erosion, cracks, slides, settlements, sinkholes, or bulges.)
Describe the damage or distress, the cause, and the location on the dam. Does the damage or distress threaten the dam? If there is cracking, is it longitudinal (parallel to the length of the embankment) or transverse (perpendicular to the length of the embankment)? If there is longitudinal cracking, is the top of the ground at different levels on either side of the crack (an indication of movement/slide). If there is transverse cracking, does the crack extend below the reservoir water level? If there is a slide, indicate the depth and if the slide has caused an increase in seepage. (If so, see Seepage.)

Other Incidents or Conditions Affecting the Safety of a Dam
These could include activation of an emergency action plan, installation of an unapproved dam, or an unapproved modification of a dam, etc.

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