Lumiform / Templates / UFA Tree Hazard Evaluation Form

UFA Tree Hazard Evaluation Form

Use this assessment form to determine whether a tree’s at risk for toppling over a losing a limb. Note the tree’s defects, its characteristics, health, and site conditions. All of this information goes into determining the hazard rating for a particular tree.

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Tree Characterics

Tree species

DBH

Number of trunks

Height

Spread

Form

Crown class

Percent of live crown

Age class

Pruning history

Tree Health

Foliage colour

Epicormics

Foliage density

Leaf size

Twig dieback

Woundwood development

Vigor class

Growth Obstructions

Major pests/diseases visible

Site conditions

Site character

Landscape type

Recent Site Distrubance

Recent site disturbance

Pavement lifted

Driveway lifted

Irrigation

% dripline paved

% dripline with fill soil

% dripline grade lowered

Soil Problems

Obstruction

Exposure to wind

Prevailing wind direction

Target

Use under tree

Can target be moved

Can use be restricted

Occupancy

Tree defect

Suspect root rot

Mushroom/conk/bracket present

Exposed roots

Undermined

Roots pruned

Roots area affected

Buttress wounded

Restricted root area

Potential for root failure

Lean degrees from vertical

Lean

Lean severity

Soil heaving

Decay in plane of lean

Roots broke

Soil cracking

Compounding factors

Hazard Rating

Tree Part Most likely to fail

Inspection period

Failure potiential

Size of part

Target rating

Hazard rating

Recommendations

Prune

Cable/Brace

Inspect further

Remove tree

Replace tree

Move target

Effect on adjacent trees

Notification

Date of notification

Comments

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.