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Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] Tree Health Evaluation Form must be completed by a certified arborist. One evaluation form per tree. SITE/ADDRESS: MAP/LOCATION: DATE: ARBORIST NAME: ARBORIST CERTIFICATION DATE OF LAST INSPECTION: I. TREE CHARACTERISTICS TREE # SPECIES: DBH: # OF TRUNKS: HEIGHT: SPREAD: FORM: ☐Generally Symmetric ☐ Minor Asymmetry ☐Major Asymmetry ☐Stump Sprout ☐Stag-headed CROWN CLASS: ☐Dominant ☐Co-Dominant ☐Intermediate ☐Suppressed LIVE CROWN RATIO: % AGE CLASS: ☐Young ☐Semi-Mature ☐ Mature ☐Over-Mature/Senescent PRUNING HISTORY: ☐Crown cleaned ☐Excessively Thinned ☐Topped ☐Crown Raised ☐Crown Reduced ☐Flush Cuts ☐Pollarded ☐None ☐Cabled/braced ☐Multiple Pruning Events Approximate Dates: SPECIAL VALUE ☐Specimen ☐Heritage/Historic ☐Wildlife ☐Unusual ☐Street Tree ☐Screen ☐Shade ☐Indigenous ☐Protected by Government Agency II. TREE HEALTH FOLIAGE COLOR: FOLIAGE DENSITY: ☐Normal ☐Normal ☐Chlorotic ☐Sparse ☐Necrotic EPICORMICS? Yes No LEAF SIZE: ANNUAL SHOOT GROWTH: WOUNDWOOD DEVELOPMENT: ☐Normal ☐Excellent ☐Excellent ☐Small ☐Average ☐Average TWIG DIEBACK? ☐Poor ☐Poor Yes ☐ No None VIGOR CLASS: ☐Excellent ☐Average ☐Fair ☐Poor GROWTH OBSTRUCTIONS: ☐Stakes ☐Wires/ties ☐Signs ☐Cables ☐Guard ☐Curb/Pavement ☐Other: MAJOR PESTS/DISEASES: III. SITE CONDITIONS SITE CHARACTER: ☐Residence ☐Commercial ☐Industrial ☐Park ☐Natural ☐Woodland/Forest ☐Open Space LANDSCAPE TYPE: ☐Parkway ☐Raised Bed ☐Container ☐Mound ☐Lawn ☐Shrub Border ☐Windbreak IRRIGATION: ☐ None ☐Inadequate ☐Adequate ☐Trunk wetted ☐ Excessive RECENT SITE DISTURBANCE? Y N ☐Construction ☐ Soil Disturbance ☐Grade Change ☐Line clearing ☐ Site Clearing % DRIPLINE PAVED: 0% 10-25% 26-50% 51-75% 76-100% PAVEMENT LIFTED? % DRIPLINE WITH FILL SOIL: 0% 10-25% 26-50% 51-75% 76-100% Yes No % DRIPLINE GRADE LOWERED: 0% 10-25% 26-50% 51-75% 76-100% Revised January 2025 ---PAGE BREAK--- Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] III. SITE CONDITIONS, CONTINUED SOIL PROBLEMS: ☐ Drainage ☐ Shallow ☐ Compacted ☐ Droughty ☐ Saline ☐ Alkaline ☐ Acidic ☐ Small Volume ☐ Disease Center ☐ History of Fail ☐ Clay ☐ Expansive ☐ Slope ☐ Aspect OBSTRUCTIONS: ☐ Lights ☐ Signage ☐ Underground Utilities ☐ Line-of-Sight ☐ View ☐ Traffic ☐ Overland Lines ☐ Adjacent Vegetation ☐ EXPOSURE TO WIND: ☐ Single Tree ☐ Below Canopy ☐ Above Canopy ☐ Recently Exposed ☐ Windward, Canopy Edge ☐ Area prone to PREVAILING WIND DIRECTION: OCCURRENCE OF SNOW/ICE STORMS: ☐ Never ☐ Seldom ☐ Regularly IV. TREE STRUCTURE ROOTS: SUSPECTED ROOT ROT: Y N MUSHROOM/CONK/BRACKET PRESENT: Y N ID: EXPOSED ROOTS: ☐ Severe ☐ Moderate ☐Low UNDERMINED: ☐ Severe ☐ Moderate ☐ Low ROOT PRUNED: Distance from trunk ROOT AREA AFFECTED: % BUTTRESS WOUNDED: Y N WHEN: RESTRICTED ROOT AREA: ☐ Severe ☐ Moderate ☐ Low LEAN: Degrees from vertical ☐ Natural DECAY IN PLANE OF LEAN: Y N ROOTS BROKEN: Y ☐ Unnatural N SOIL CRACKING: Y N ☐ Self-corrected SOIL HEAVING Y N COMPOUNDING FACTORS: LEAN SEVERITY: ☐ Severe ☐ Moderate ☐ Low CROWN: Indicate presence of individual defect’s location (root crown, trunk, scaffolds, branches) & rate their severity (S=severe, H=high, M= moderate, L= low) Defect Defect Area Defect Severity Defect Defect Area Defect Severity Poor Taper Decay Bow, Sweep Cavity Co-Dominants, Forks Conks/Mushroom/Bracket Multiple Attachments Bleeding/Sap Flow Included Bark Loose/Cracked Bark Excessive End Weight Nesting Hole/Bee Hive Cracks/Splits Deadwood/Stubs Hangers Borers/termite/ants Girdling Cankers/Galls/Burl Wounds/Seam Previous Failure V. RISK RATING SIZE OF DEFECTIVE PART ☐ 1 POINT ☐ 2 POINTS ☐ 3 POINTS 1 Point Parts less than 4 inches in diameter 2 Points Parts from 4 to 20 inches in diameter 3 Points Parts greater than 20 inches in diameter DESCRIPTION & COMMENTS: OTHER RISK FACTORS ☐ 0 POINTS ☐ 1 POINT ☐ 2 POINTS This category can be used if professional judgment suggests the need to increase the risk rating. It can also be used if the tree is likely to fail before the next scheduled risk inspection. ---PAGE BREAK--- Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] V. RISK RATING, CONTINUED DESCRIPTION & SEVERITY: TREE PART MOST LIKELY TO FAIL: INSPECTION PERIOD: annual biannual other PROBABILITY OF FAILURE ☐ 1 POINT ☐ 2 POINTS ☐ 3 POINTS ☐ 4 POINTS Point Risk Description Part Description 1 Low Some minor defects • Minor branch/crown dieback • Minor defects or wounds 2 Moderate Several moderate defects present • Indicators of advanced decay are found on 25-40% of circumference of any stem, branch, or root collar. • Shell thickness is >1 and <2 inches of sound wood for each 6 inches of stem diameter and stem has opening < 30% of stem circumference. • Stem has a single crack and decay • Roots within the area defined by the Critical Root Radius are less than or equal to 40% damaged, decayed, severed, or dead. • Branch union has included bark. • Canker or canker plus decay affect 25-40% of tree’s circumference • Branch has a sharp bend or twist. • Large horizontal branch with several vertical branches on it. 3 High Multiple or significant defects present • Indicators of advanced decay are found on more than 40% of the circumference of any stem, branch or root collar. • Stem has advanced decay and the shell thickness is either less than 1 inch of sound wood for each 6 inches of stem diameter, or stem has opening greater than 30% of the stem circumference and shell thickness is less than 2 inches of sound wood for each 6 inches of stem diameter. • Stem is split in two by a crack or branch has a crack. • Stem segment has multiple cracks and decay. • Leaning tree with recent evidence of root lifting, soil movement or soil mounding. • Roots within the area defined by the Critical Root Radius are more than 40% damaged, decayed, severed, or dead. • Weak union is also cracked, cankered, or decayed. • Large epicormic branch on decaying stem. • Canker or canker plus decay affect more than 40% of tree’s circumference. • Tree with excessive lean (more than 40%). • Leaning tree has a crack in stem or canker or decay on lower stem. • Leaning tree has a horizontal crack on the upper side of the lean and/or buckling bacrk and wood on lower side. • Any lodged branch. • Any dead tree, tree top, or branch. 4 Severe Multiple AND significant defects present listed under “High” risk; visual obstruction of traffic signs/ lights or intersections DESCRIPTION & COMMENTS: TOTAL RISK RATING (SIZE OF PART + OTHER RISK FACTORS + FAILURE POTENTIAL): RISK RATING : ☐ Low (0-1 points) ☐ Moderate (2-3 Points) ☐ High (4-6 points) ☐ Severe (7-9 points) VI. RISK ABATEMENT PRUNE: ☐ Remove Defective part ☐ Reduce end weight ☐ Crown clean ☐ Thin ☐ Raise canopy ☐ Crown reduce ☐ Restructure ☐ Shape CABLE/BRACE: INSPECT FURTHER: ☐ Root crown ☐ Decay ☐ Aerial ☐ Monitor REMOVE TREE? Y N REPLACE? Y N OTHER: EFFECT ON ADJACENT TREES: DATE: