Manhole Cover Inspection Report
Date: ________________
Inspector: ________________
Location: ________________
Manhole Cover Type: ________________
Manhole Cover Size: ________________
Manhole Cover Material: ________________
Inspection Results:
1. Cover Condition:
□ No visible damage or cracks
□ Minor damage or cracks
□ Major damage or cracks
□ Missing or broken cover
2. Cover Alignment:
□ Cover is level with the road surface
□ Cover is raised above the road surface
□ Cover is lower than the road surface
3. Cover Stability:
□ Cover is stable and does not move when stepped on
□ Cover is unstable and moves when stepped on
4. Frame Condition:
□ No visible damage or cracks
□ Minor damage or cracks
□ Major damage or cracks
5. Frame Alignment:
□ Frame is level with the road surface
□ Frame is raised above the road surface
□ Frame is lower than the road surface
6. Frame Stability:
□ Frame is stable and does not move when stepped on
□ Frame is unstable and moves when stepped on
7. Surrounding Area:
□ No visible damage or cracks
□ Minor damage or cracks
□ Major damage or cracks
8. Other Observations:
□ No other observations
□ Other observations: ____________________________________________________________
Recommendations:
□ No action required
□ Minor repairs required
□ Major repairs required
□ Replacement required
Inspector's Signature: ___________________________
Date: ________________"