Name *

Phone Number

Email Address *

Project Location *

Is this a new or exisiting culvert? Is this a new or exisiting culvert?NewExisting

Culvert Width/Diameter (mm) *

Culvert Gradient (%) * Culvert Gradient (%) *Less than 1.0%1.0 - 2.0%2.0 - 3.0%3.0 - 4.0%Greater than 4.0%

Culvert Length (m) *

Culvert Shape * Culvert Shape *RoundBoxPipe ArchOther

Fish species likely to pass through? * Fish species likely to pass through? * Small-bodied fish (e.g. īnanga, kōaro, galaxiids) Large-bodied fish (e.g. tuna/eel, trout, salmonids) Other / not sure

Is the culvert perched? * Is the culvert perched? * Yes, there’s a drop at the outlet No, it’s flush with the streambed Not sure / I need help checking

Does this culvert have an apron? * Does this culvert have an apron? * No Yes

Do you want offset installation? * Do you want offset installation? * Yes No Not sure / I want more information

Does the apron require fish passage? *

Additional notes (optional)