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WESTERN RESERVE ENGINEERING & SURVEYING COMPANY <br />MANHOLE INSPECTION FORM <br />INSTRUCTIONS <br />This form is intended to be a general format that will fit most manhole applications found in the <br />field. Its purpose is to gather as much information as possible, during an inspection, without <br />being cumbersome to use. <br />The form is divided into six (6) major categories; Heading, Surface Data, Sketch, Manhole <br />Structure, Piping Configuration, and Comments. It has been set-up to move progressively <br />through the sheet form top to bottom in the same manner the inspection would physically be <br />performed. If more space for field sketches, comments or complex structures is needed, the <br />reverse side can be used. <br />Directions and clarifications for this form are as follows: <br />1. Project Name - Self-explanatory. <br />2. Location - Use this line for a description of where the manhole is located (i.e., street <br />name, alley, easement, etc.). <br />3. Date - Day of inspection. <br />4. Crew - Initials of crew members. <br />5. Weather - Dry, rain, snow, and temperature. <br />6. Minisystem - Used to identify a known area or community. <br />7. Manhole I.D. - An alphanumeric numbering system or a conesponding field I.D. number <br />relative to a composite field sketch. <br />8. Manhole Type - Circle sanitary, storm or combined. <br />9. Surface Data: <br />a. Manhole Location - Circle appropriate word(s) which best describe the location. <br />b. Pavement Condition/Type - Circle the appropriate word(s) which best describe <br />the pavement area surrounding the manhole. <br />- 1 -