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Manhole Inspection Form <br />DATE- <br />OPERATOR - <br />BASIN # <br />IN FRONT OF RESIDENCE- <br />WALL CONDITION cracks no cracks roots <br />lining <br />material <br />missing <br />other <br />WALL MATERIAL TYPE concrete brick plastic other <br />BASE CONDITION good poor severe <br />no base - <br />erroded other <br />EVIDENCE OF SURCHARGE?yes no mild severe <br />FLOW CONDITION good poor fast slow no flow <br />INVERT DEPTH MEASUREMENT <br />GREASE yes no mild severe <br />ROOTS yes no mild severe <br />MANHOLE COVER TYPE holes no holes <br />DATE- <br />OPERATOR - <br />BASIN # <br />IN FRONT OF RESIDENCE- <br />WALL CONDITION cracks no cracks roots <br />lining <br />material <br />missing <br />other <br />WALL MATERIAL TYPE concrete brick plastic other <br />BASE CONDITION good poor severe <br />no base - <br />erroded other <br />EVIDENCE OF SURCHARGE?yes no mild severe <br />FLOW CONDITION good poor fast slow no flow <br />INVERT DEPTH MEASUREMENT <br />GREASE yes no mild severe <br />ROOTS yes no mild severe <br />MANHOLE COVER TYPE holes no holes <br />6.2.A. - Page 85