Laserfiche WebLink
Manhole Inspection Header Form Level 1 & Level 2 Inspections <br />Surveyed By (1) Certificate Number (2) Owner (3) Customer (4) <br />ABARAHAM BARTON U-1014-06022532__ Santa Ana __J — <br />Drainage Area (5) Sheet Number (6) PO Number (7) Date (8) <br />Time (9) Street (No. & Name) (10) City(11) <br />Location Details (12) <br />2/1/2017 11:22 Old Grand _� <br />_ <br />Santa Ana <br />Manhole Number (13) Rim to Invert (14) <br />C11-050 �1 ��®�r. <br />Grade to Invert (15) <br />Rim to Grade (16) <br />MH Use (17) Year Built (18) <br />Sanitary I IF— <br />Year Renewed (19) <br />Media Label (20) <br />Purpose (21) Category (22) <br />Pre -Cleaning (23) <br />Date Cleaned (24) <br />Maintenancerelated��-���--��r-^� <br />Weather (25)Location Code (26) <br />Additional Info (27) <br />Surface Type (28) <br />_ <br />�_ Light Highway Jr <br />Potential for Runoff (29) Access Type (30) <br />__ <br />1 <br />Northing (31) <br />Surfac0 Type Asphalt <br />Easting (32) <br />_ <br />1 Manhole _��1 <br />Elevation (33) Coordinate System (34) <br />GPS Accuracy (35) <br />Inspection Status (36) <br />Evidence of Surcharge Inspection Level (38) <br />(37) <br />No ��et 1 <br />Manhole Inspection Header Form Level 1 & Level 2 Inspections <br />Cover Shape Cover Size (41) Cover Size Cover Material Cover Type (44) Hole Diameter <br />(40) Width (49) (43) (45) <br />'cover <br />Type _. ' 1/2 Inch <br />Cov <br />Circular 25 Cast Iron cov (13mm) < 1 <br />L9oltinch 25mm <br />Holes Number Cover Bearing Cover Bearing <br />(46) Surface Dia. Surface Dia <br />(41) Width (48) <br />Cover Frame Fit Cover Condition Cover Insert <br />(49) (50) Type (51) <br />Cover <br />5 Good Condition None <br />Sound <br />Cover Insert Adjustment Adjustment Ring Ring Condition Adjustment Ring Frame Material <br />Condition (52) Ring Type (53) Material (54) (55) Height (56) (57) <br />NoneE== E== E===Cast Iron <br />Frame Bearing Frame Bearing Frame Clear <br />Surface Width Surf Depth (59) Opening Dia <br />(58) (60) <br />Frame Condition Frame Seal Frame Offset <br />(61) Condition (62) Distance (63) <br />Frame Seal Condition <br />Condition Sound 0 <br />Sound <br />Frame Seal Frame Depth Chimney Chimney Clear Chimney Depth <br />Inflow (64) (65) Material (66) Chimney 1/1 (67) Opening (68) (69) <br />Infil Dr er Concrete (non- Infil Dri er <br />reinforced —- <br />2�J'b$� <br />