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' � IS�� Basic Tree Risk Assessment Form <br /> Client �� T(ZA�J i M,/}l� Date ��l Z��� Time ��" 30 �� <br /> Address/Tree location � 3 I o ELM Vv'ct�0 v_ nnov�vD M� • Tree no. Sheet of <br /> Tree species 55w��1� T► L( M�=1� � dbh���'�= 1�L�KHeight ��� Crown spread dia. 3�� <br /> Assessor(s) 17Rr'H� F,.r���21 C�So� Tools used Time frame <br /> TargeF Assessment <br /> .. - �� <br /> d <br /> a <br /> � F o�. <br /> � Targetdescription � � _ ..� + j j, , , f 'c F <br /> i0 N u <br /> f0 <br /> F' � / + K G <br /> 1 J�H�(� �' (���� s..,; ` �..»�.. , ,,, . <br /> Z �� �� �oG� �.. <br /> 3 �Q� s . J,� �Q�-, I ,2,� v�w�►�F� <br /> 4 �zk <br /> S�tE �`ra � s� "� g� g — <br /> Historyoffailures �--��'�� �-.c�`�`� 1 J <br /> Site changes None❑ Grade change�te clearing0 C�ha�n ed soil hyc l �-<<� ��7iUrv <br /> Soil conditions Limited volume�Saturated❑ Shallow G3'Compacted[ � ���'� <br /> Prevailing wind direction �,�/ Common weather Strong winds[a I � ��� �� ""'� <br /> Tree Nealth a ( l 1 O �' 1���� _ <br /> �� <br /> Vigor Low❑ Normal High❑ Foliage None(seasonal)❑ _% <br /> Pests/Biotic <br /> Speciesfailureprofile eranches❑ Trunk Roots❑ Describe �`'�+���P TiZ�nir WQ4:v.D o� /�i„Q�v ,ti�� ���1 <br /> Load Factors <br /> Wind exposure Protected❑ Partial❑ Full Wind funneling❑ Relative crown size Small❑ Medium❑ Large� <br /> Crown density Sparse❑ Normal❑ Dense�lnterior branches Few� Normal�S �ense❑ Vines/Mistletce/Moss� V'r''�s <br /> Recent or expected change in load factors T��%'�%k ��'+��G� <br /> Tree Defects and Conditions Affecting the Likelihood of Failure <br /> —Crown and Branches— <br /> Unbalanced crown❑ LCR �C' % ,� .� Cracks❑ Lightning damage <br /> Dead twigs/brenches❑ � %overall Max.dia.�_ � "^—�K 5 Included bark <br /> Codominant �� g � U�2 � <br /> Broken/Hangers Number Max.dia. <br /> Over-extended branches ❑ Weak attachments Cavity/Nest hole%circ. <br /> Previous branch failures Similar branches present ❑ <br /> Pruning history �/ <br /> Crown cleaned ❑ Thinned ❑ Raised ❑ Dead/Missing bark[3'Cankers/Galls/Burls O�wood damage/decay <br /> Reduced ❑ Topped ❑ Lion-tailed ❑ Conks ❑ Heartwood decay <br /> Flush cuts ❑ Other Response growth ��'��"�� ��D ,..��; C�✓:�'r ti�.. <br /> Condition�s)ofconcern �� � �'"��-- �S �'�`�'�-��_�� <br /> Part Size Fall Distance Part Size Fall Distance <br /> LAad on defect N/A❑ Minor ❑ Moderate�❑�ignificant C� Load on defed N/A� Minor ❑ Moderate�0 �Si nificant <br /> Likelihoodoffailure Improbable0 Possible❑ Probable L7 Imminent❑ Likelihoodoffailure Improbable❑ Possible❑ Probable C�Imminent❑ <br /> —Trunk— —Roots and Root Collar— <br /> Dead/Missing bark Q"/ Abnormal bar exture/color Collar buried/Not visible C�" Depth Stem girdling <br /> Codominant stems Cil' —/ Included bark� Cracks❑ Dead ❑ Decay ld� Conks/Mushrooms❑ <br /> Sapwood damage/d�e/cay C� Cankers/Galls/Burls❑ Sap ooze ❑ Ooze ❑ Cavity❑ `Y circ. <br /> Lightning damage G�' Heartwood decayl� Conks/Mushrooms❑ Cracks❑ Cut/Damaged roots❑ Distance from trunk <br /> Cavity/Nest hole �U%circ. Depth Poor taper Root plate lifting❑ Soil weakness❑ <br /> Lean ° CorrectIed? �7bj /}CLF��LC= <br /> Response growth j'1����"'� w00� IJu►A(��Lr Response growth <br /> ul�- Ccw+ C+' o� A�l �Z�nsK Conditi n(s)pfconcem �'� �' C�''�F��'�d`'✓ ON /} LL 3 <br /> Condition(s)of concern 5= � .3 1 5 �-,��N r 5 „ , , � <br /> Part Size Z�+ 2 �' ` Fall Distance ��� Part Size '1-" 'Z� t ZJ Fall Distance �G <br /> Load on defeCt N/A❑ Minor ❑ Moderate❑ Significant Load on defect N/A❑ Minor ❑ Moderate❑ $ignificant� <br /> Likelihoodoffailure tmprobable❑ Possible❑ Probable E3 Imminent❑ Likelihoodoffailure Improbable❑ Possible❑ Probable B�mminent❑ <br /> Page I of 2 <br />