1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORROSION
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/25/2017
U-1209-6134
1:13PM MACP LEVEL -1
MH-0698
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code Y
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: INGLEWOOD
MANHOLE CONDITION ASSESSMENT FORM
ON 6TH ST BETWEEN ARDMORE AVE AND PCH CLOSER TO PCH
4/17/2017
U-1209-6134
2:57PM MACP LEVEL -1
MH-0699
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
6TH ST A.SOUZA
Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
END OF 7TH ST EAST OF ARDMORE AVE
4/17/2017
U-1209-6134
2:50PM MACP LEVEL -1
MH-0700
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
7TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
3:22AM MACP LEVEL -1
MH-0701
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
VALLEY DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments FRAME IS OFFSET
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 8TH ST BETWEEN BARD ST AND CYPRESS AVE
4/17/2017
U-1209-6134
10:24AM MACP LEVEL -1
MH-0702
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
8TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code Y
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments ON DRIVEWAY
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
TOP OF BARD ST ABOVE 8TH ST
4/12/2017
U-1209-6134
7:41AM MACP LEVEL -1
MH-0703A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
BARD ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code B
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
TOP OF CYPRESS AVE NEAR CLARK STADIUM
4/12/2017
U-1209-6134
7:26AM MACP LEVEL -1
MH-0704
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CYPRESS AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
END OF CYPRESS NEAR CLARK STADIUM
4/12/2017
U-1209-6134
7:30AM MACP LEVEL -1
MH-0705
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CYPRESS AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON CYPRESS AVE JUST ABOVE 8TH ST
4/17/2017
U-1209-6134
10:28AM MACP LEVEL -1
MH-0706
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CYPRESS AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON BARD ST JUST ABOVE 8TH ST
4/12/2017
U-1209-6134
7:37AM MACP LEVEL -1
MH-0707
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
BARD ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 6
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 11TH ST NEAR CYPRESS AVE
4/10/2017
U-1209-6134
3:10PM MACP LEVEL -1
MH-0708
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
11TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE CYPRESS AVE AND 11TH ST MEET
4/10/2017
U-1209-6134
3:16PM MACP LEVEL -1
MH-0709
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
11TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 11TH ST NEAR LOMA DR
4/10/2017
U-1209-6134
3:19PM MACP LEVEL -1
MH-0710
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
11TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 6
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
2:41AM MACP LEVEL -1
MH-0711
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
BARD ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
2:44AM MACP LEVEL -1
MH-0712
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
BARD ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 4
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
2:47AM MACP LEVEL -1
MH-0713
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PIER AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PIER AVE AND CYPRESS AVE
5/31/2017
U-1209-6134
2:51AM MACP LEVEL -1
MH-0714
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PIER AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 2
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PIER AVE AND LOMA DR
5/31/2017
U-1209-6134
2:59AM MACP LEVEL -1
MH-0715
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PIER AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
4/11/2017
U-1209-6134
7:35AM MACP LEVEL -1
0716X
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 4
3 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 2
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CRACK
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CRACK
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON LOMA DR JUST ABOVE 11TH ST
4/11/2017
U-1209-6134
7:41AM MACP LEVEL -1
MH-0717
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
LOMA DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 4
1 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED MISSING PART OF STEP
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON CYPRESS AVE JUST BELOW PIER AVE
4/10/2017
U-1209-6134
3:29PM MACP LEVEL -1
MH-0718
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CYPRESS AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 4
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 2
Bench Deffect Comments
Channel Condition 2
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON CYPRESS AVE JUST ABOVE 11TH ST
4/10/2017
U-1209-6134
3:25PM MACP LEVEL -1
MH-0719
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CYPRESS AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments CONCRETE AND ASPHALT FOR SURFACE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED PART MISSING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON CYPRESS AVE JUST BELOW PIER AVE
4/10/2017
U-1209-6134
3:32PM MACP LEVEL -1
MH-0720
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CYPRESS AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 5
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF ARDMORE AVE AND 16TH ST
4/4/2017
U-1209-6134
2:07PM MACP LEVEL -1
MH-0722
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THERE METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 2
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE ITS METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON ARDMORE JUST ABOVE 16TH ST
4/4/2017
U-1209-6134
2:38PM MACP LEVEL -1
723
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 3
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON ARDMORE JUST BELOW AN ALLEY BELOW 21ST ST
4/4/2017
U-1209-6134
2:44PM MACP LEVEL -1
MH-0724
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE ITS METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE ITS METAL WITH A PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
JUST BELOW 21ST ST ACROSS FROM ALLEY
4/4/2017
U-1209-6134
2:50PM MACP LEVEL -1
MH-0725
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CRACK
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF ARDMORE AVE AND 21ST ST
4/4/2017
U-1209-6134
2:56PM MACP LEVEL -1
MH-0726
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
4:23AM MACP LEVEL -1
MH-0727
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 2
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
4:29AM MACP LEVEL -1
MH-0728
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
EROSION
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
4:32AM MACP LEVEL -1
MH-0729
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
4:38AM MACP LEVEL -1
MH-0730
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code 1
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CRACK
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CRACK
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF PORTER LN AND ARDMORE AVE
5/16/2017
U-1209-6134
1:32PM MACP LEVEL -1
MH-0731
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ARDMORE AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 4
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF PORTER LN ABOVE ARDMORE
3/27/2017
U-1209-6134
11:30AM MACP LEVEL -1
MH-0732
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PORTER LN A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 2
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THER METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
TOP OF PORTER LN JUST BELOW PCH
3/27/2017
U-1209-6134
11:41AM MACP LEVEL -1
MH-0732A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PORTER LN A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 4
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
TOP OF 25TH ST
3/27/2017
U-1209-6134
11:47AM MACP LEVEL -1
MH-0734
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
25TH ST A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO STEPS
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
BETWEEN ARDMORE AVE AND PCH ON 24TH PL
4/3/2017
U-1209-6134
9:18AM MACP LEVEL -1
MH-0735
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
24TH PL A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 3
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CHANNEL TOP OF LINE
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
11:19PM MACP LEVEL -1
MH-0736
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
24TH PL A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
2 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
LIGHT ROOTS
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF 24TH ST BETWEEN PCH AND ARDMORE AVE
4/3/2017
U-1209-6134
9:30AM MACP LEVEL -1
MH-0737
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
24TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO STEPS
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 24TH ST JUST BELOW PCH
4/3/2017
U-1209-6134
9:36AM MACP LEVEL -1
MH-0738
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
24TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
21ST AND AVA AVE
4/3/2017
U-1209-6134
10:49AM MACP LEVEL -1
MH-0739
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 1
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED OFF MISSING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
UNKNOWN OBJECT IN HOLE OF WALL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 21ST ST
58/31/17
U-1209-6134
11:44PM MACP LEVEL -1
MH-0740
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
11:23PM MACP LEVEL -1
MH-0741
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 24TH PL
5/31/2017
U-1209-6134
11:14PM MACP LEVEL -1
MH-0742
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
4:46AM MACP LEVEL -1
MH-0743
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORROSION
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO STEPS
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
LIGHT ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF AVA AVE ST
4/3/2017
U-1209-6134
11:04AM MACP LEVEL -1
MH-0744
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVA AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF SPRINGFIELD AVE BELOW 21ST ST
4/3/2017
U-1209-6134
9:57AM MACP LEVEL -1
MH-0745
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
SPRINGFIELD AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code H
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
2 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
ROOTS
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ALLEY OFF OF SPRINGFIELD AVE
4/3/2017
U-1209-6134
10:06AM MACP LEVEL -1
MH-0746
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
NA
Chimney O&M Comments
Cone: Condition NA
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition NA
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON SPRINGFIELD AVE JUST BELOW 21ST ST
4/3/2017
U-1209-6134
9:52AM MACP LEVEL -1
MH-0747
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
SPRINGFIELD AVE A.SOUZA
Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
TOP OF LINE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CONE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO STEPS
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CHANNEL
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
TOWARDS THE END OF THE CULDISAC ON SPRINGFIELD AVE BEFORE
CLEANOUT
4/3/2017
U-1209-6134
10:41AM MACP LEVEL -1
MH-0748
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
SPRINGFIELD AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON AVA AVE JUST BELOW 21ST ST
4/3/2017
U-1209-6134
10:57AM MACP LEVEL -1
MH-0749
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVA AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CONE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO STEPS
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
END OF THE CULDISAC ON AVA AVE
4/3/2017
U-1209-6134
11:17AM MACP LEVEL -1
MH-0750
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVA AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
1:07AM MACP LEVEL -1
MH-0751
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
16TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition NA
Cone O&M Comment
Wall: Condition NA
Wall O&M Comment
Bench: Condition NA
Bench Deffect Comments
Channel Condition NA
Channel Deffect Comments
Steps: Material NA
# of Steps
General Comments SMALL HOLE TO SEWER LINE COVERED WITH CONCRETE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
1:05AM MACP LEVEL -1
MH-0751A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
16TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 2
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED OFF
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
12:29AM MACP LEVEL -1
MH-0752
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 4
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
12:57AM MACP LEVEL -1
MH-0752A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
16TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 3
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CONE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
1:01AM MACP LEVEL -1
MH-0752B
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
16TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 16TH
5/31/2017
U-1209-6134
12:32AM MACP LEVEL -1
MH-0753
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED MISSING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 17TH ST
5/31/2017
U-1209-6134
12:36AM MACP LEVEL -1
MH-0754
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments 1
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
12:40AM MACP LEVEL -1
MH-0755
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 19TH ST
5/31/2017
U-1209-6134
12:45AM MACP LEVEL -1
MH-0756
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 21ST ST
5/31/2017
U-1209-6134
11:49PM MACP LEVEL -1
MH-0757
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 2
Bench Deffect Comments
Channel Condition 2
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
11:27PM MACP LEVEL -1
MH-0758
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
11:31PM MACP LEVEL -1
MH-0759
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 21ST ST NEAR BORDEN AVE
4/6/2017
U-1209-6134
1:03PM MACP LEVEL -1
MH-0761
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF 21ST AND BORDEN AVE
4/6/2017
U-1209-6134
1:08PM MACP LEVEL -1
MH-0762
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 5
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE ITS METAL WITH A PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
RHODES ST AND 21ST ST
4/6/2017
U-1209-6134
1:21PM MACP LEVEL -1
MH-0763
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
21ST ST AND HILLCREST DR
4/6/2017
U-1209-6134
1:31pm MACP LEVEL -1
MH-0764
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
21ST ST AND HILLCREST DR
4/6/2017
U-1209-6134
1:38PM MACP LEVEL -1
MH-0764A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
END OF CULDISAC ON HILLCREST DR
4/6/2017
U-1209-6134
11:31AM MACP LEVEL -1
MH-0764B
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
HILLCREST DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON HILLCREST DR MIDDLE OF ST
4/6/2017
U-1209-6134
11:28AM MACP LEVEL -1
MH-0764C
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
HILLCREST DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
2 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
PIECES OF WOOD BETWEEN FRAME AND CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 21ST ST NEAR PROSPECT AVE
4/6/2017
U-1209-6134
1:44PM MACP LEVEL -1
MH-0765
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 2
Channel Deffect Comments
Steps: Material 3
# of Steps 12
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:36AM MACP LEVEL -1
MH-0766
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THERE METAL WITH A PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
EROSION
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 3
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 3
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CONE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CHANNEL
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
21ST ST AND HARPER AVE
4/6/2017
U-1209-6134
10:31AM MACP LEVEL -1
MH-0767
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
21ST ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:18AM MACP LEVEL -1
MH-0768
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 3
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:41AM MACP LEVEL -1
MH-0769
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THERE METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:44AM MACP LEVEL -1
MH-0770
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON HILLCREST DR JUST BELOW 21ST ST
4/6/2017
U-1209-6134
3:34PM MACP LEVEL -1
MH-0771
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
HILLCREST DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code Y
Inspection Status SI
Access Type: AMH
Surface Type: 4
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 3
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO WALL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON GRASS BETWEEN 19TH AND 20TH ST
4/6/2017
U-1209-6134
2:59PM MACP LEVEL -1
MH-0772
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
RHODES ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
TOP OF BORDEN AVE ABOVE 21ST ST
4/6/2017
U-1209-6134
11:39AM MACP LEVEL -1
MH-0773
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
BORDEN AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code H
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 2
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED AND PITTED
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
BETWEEN 21ST AND 20TH ST
4/6/2017
U-1209-6134
1:59PM MACP LEVEL -1
MH-0774
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ALLEY BETWEEN 20TH ST AND 19TH ST
4/6/2017
U-1209-6134
2:08PM MACP LEVEL -1
MH-0775
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code H
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 3
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CHANNEL
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ALLEY NEXT TO RHODES ST BETWEEN 20TH AND 19TH
4/6/2017
U-1209-6134
2:14PM MACP LEVEL -1
MH-0776
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code H
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 3
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CHANNEL
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ALLEY NEAR RHODES ST AND BETWEEN 20TH AND 21ST
4/6/2017
U-1209-6134
2:02PM MACP LEVEL -1
MH-0777
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 2
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 19TH ST NEAR RHODES ST
4/6/2017
U-1209-6134
3:08PM MACP LEVEL -1
MH-0778
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
19TH ST A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
LOOKS BOKEN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
18TH ST JUST BEFORE PCH
4/7/2017
U-1209-6134
12:06PM MACP LEVEL -1
MH-0779
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
18TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 5
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THESE ARE METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
18TH AND RHODES ST
4/7/2017
U-1209-6134
11:43AM MACP LEVEL -1
MH-0780
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
18TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 2
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF 18TH AND HILLCREST DR
4/7/2017
U-1209-6134
11:36AM MACP LEVEL -1
MH-0781
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
18TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
11:00AM MACP LEVEL -1
MH-0782
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 6
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THER METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 18TH ST JUST BEFORE PROSPECT AVE
4/7/2017
U-1209-6134
10:18AM MACP LEVEL -1
MH-0782A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
18TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 2
Cone O&M Comment
Wall: Condition 2
Wall O&M Comment
Bench: Condition
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 4
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:57AM MACP LEVEL -1
MH-0783
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORROSION MISSING 1
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ROOTS
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:48AM MACP LEVEL -1
MH-0784
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORROSION
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 4
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
10:52AM MACP LEVEL -1
MH-0784A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
11:05AM MACP LEVEL -1
MH-0785
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON HILLCREST DR JUST ABOVE 18TH ST
4/6/2017
U-1209-6134
3:22PM MACP LEVEL -1
MH-0786
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
HILLCREST DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF HILLCREST DR BETWEEN 21ST ST AND 18TH ST
4/6/2017
U-1209-6134
3:34PM MACP LEVEL -1
MH-0787
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
HILLCREST DR A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THERE METAL WITH A PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON RHODES JUST ABOVE 18TH ST
4/6/2017
U-1209-6134
3:12PM MACP LEVEL -1
MH-0788
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
RHODES ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 3
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
I BELIEVE THERE METAL WITH PLASTIC COATING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF RHODES ST AND 19TH ST
4/6/2017
U-1209-6134
3:03PM MACP LEVEL -1
MH-0790
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
RHODES ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF 17TH ST 2ND MH PAST RAYMOND AVE
4/7/2017
U-1209-6134
1:04PM MACP LEVEL -1
MH-0792
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
17TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code 1
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE 17TH AND PROSPECT AVE MEET
4/7/2017
U-1209-6134
1:13PM MACP LEVEL -1
MH-0793
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
17TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF 16TH AND RAYMOND AVE
4/7/2017
U-1209-6134
2:02PM MACP LEVEL -1
MH-0794
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
16TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON 16TH ST JUST PAST RAYMOND ST
4/7/2017
U-1209-6134
1:59PM MACP LEVEL -1
MH-0795
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
16TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
CORNER OF 15TH PL
4/7/2017
U-1209-6134
2:08PM MACP LEVEL -1
MH-0798
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
15TH PL A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
SURFACE TYPE IS ASPHALT AND CONCRETE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 2
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
ERODED
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON RAYMOND AVE BETWEEN 17TH AND 16TH ST
4/7/2017
U-1209-6134
2:46PM MACP LEVEL -1
MH-0800
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
RAYMOND AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code H
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 3
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CONE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
BETWEEN PCH AND ARDMORE ABOVE 16TH ST BELOW 18TH ST. IN
CONDO OR APARTMENT AREA
5/30/2017
U-1209-6134
12:18PM MACP LEVEL -1
MH-0801
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code H
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 3
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
BETWEEN PCH AND ARDMORE ABOVE 16TH AND BELOW 19TH. LOOKS
LIKE APARTMENT OR CONDO AREA
5/30/2017
U-1209-6134
12:12PM MACP LEVEL -1
MH-0802
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
ALLEY A.SOUZA
Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
NO CONE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code D
Inspection Status SI
Access Type: AMH
Surface Type: 4
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments SURFACE IS DIRT AND MULCH
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/31/2017
U-1209-6134
1:18AM MACP LEVEL -1
MH-0806
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PIER AVE A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND PIER AVE
5/31/2017
U-1209-6134
12:08AM MACP LEVEL -1
MH-0807
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 2
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 13TH ST
5/31/2017
U-1209-6134
12:19AM MACP LEVEL -1
MH-0808
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 2
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
PCH AND 11TH PL
5/31/2017
U-1209-6134
12:15AM MACP LEVEL -1
MH-0809
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PACIFIC COAST HIGHWAY A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 4
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 5
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORRODED 1 MISSING
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE AVIATION BLVD AND AUBREY PARK CT MEET
4/10/2017
U-1209-6134
10:30AM MACP LEVEL -1
MH-0812
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVIATION BLVD A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 2
General Comments MH IS NOT NUMBERED ON MAP SO WE CALLED IT 812A SINCE ITS NEXT TO 812
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE AVIATION BLVD AND AUBREY PARK CT MEET MIDDLE OF
CROSSWALK
4/10/2017
U-1209-6134
10:38AM MACP LEVEL -1
MH-0812A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVIATION BLVD A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 4
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE AVIATION BLVD AND BONNIE BRAE ST MEET
4/10/2017
U-1209-6134
8:18AM MACP LEVEL -1
MH-0816
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVIATION BLVD A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments SURFACE IS ASPHALT AND CONCRETE
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
ON AVIATION BLVD BEFORE BONNIE BRAE ST
4/10/2017
U-1209-6134
8:13AM MACP LEVEL -1
MH-0816A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVIATION BLVD A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 2
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE AVIATION BLVD AND CORONA ST MEET
4/10/2017
U-1209-6134
7:40AM MACP LEVEL -1
MH-0818
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVIATION BLVD A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code F
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
MIDDLE OF CORONA ST BETWEEN AVIATION BLVD AND 14TH ST
4/10/2017
U-1209-6134
7:31AM MACP LEVEL -1
MH-0818A
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
CORONA ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
11:26AM MACP LEVEL -1
MH-0819
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
AVIATION BLVD A.SOUZA
Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING 1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
INTERSECTION OF 14TH AND PROSPECT AVE
4/7/2017
U-1209-6134
9:56AM MACP LEVEL -1
MH-0820
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
14TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
3 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material NA
# of Steps 0
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
NO CHIMNEY
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
AT 14TH ST AND HARPER AVE
4/7/2017
U-1209-6134
10:04AM MACP LEVEL -1
MH-0821
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
14TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 2
Cover Type: 5
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 3
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
WHERE 15TH AND PROSPECT AVE MEET
4/7/2017
U-1209-6134
9:45AM MACP LEVEL -1
MH-0822
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
15TH ST A.SOUZA
1 Inspection Date: Inspection Time:
Street Name Survey By: MH/ACCESS #.:
Survey Purpose MACP # Field Book Page:
Location Comments: CITY
OBSERVATION CODE TYPE CODE
Location Code C
Inspection Status SI
Access Type: AMH
Surface Type: 1
Cover Type: 10
Fit: 1
Condition 1
Cover Adjustment Ring NA
Frame: Condition 1
1 Chimney O&M Comments
Cone: Condition 1
Cone O&M Comment
Wall: Condition 1
Wall O&M Comment
Bench: Condition 1
Bench Deffect Comments
Channel Condition 1
Channel Deffect Comments
Steps: Material 2
# of Steps 1
General Comments
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
CORROSION
1.BRICK 2.METAL 3.PLASTIC 4.OTHER
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1) ASPHALT 2) CONCRETE 3) GRAVEL 4) GRASS / DIRT 5) OTHER
1.BOLTED 2.GASKET 3.SOLID 4.INNER-COVER 5.LOCKING 6.HATCH-SINGLE 7.HATCH-DOUBLE
8.LAMPHOLE 9.REMOVABLE-CENTER-COVER 10.VENTED
(ACB) CATCH BASIN (ACOH) CLEANOUT HOUSE (ACOM) CLEANOUT MAINLINE (ACOP) CLEANOUT
PROPERTY (AJB) JUNCTION BOX (AM) METER (AMH) MANHOLE (AOC) OTHER SPECTIAL STRUCTURE (AWA )WASTE WATER ACCESS (AWW) WET WELL
1.SOUND 2.DEFFECTIVE 3.NOT KNOWN
1.SOUND 2.BOLT MISSING 3.BORKEN 4.CORRED (PITTED) 5.CRACKED 6.MISSING 7.RESTRAINT-MISSING
8.RESTRAINT-DEFECTIVE
1) GOOD 2) TIGHT 3) LOOSE 4) ROCKING 5) BOLT MISSING 6) GASKET BAD/GONE 7) GOOD O-RING Chimney Condition
(DI)ENTRY INSPECTION (SI) FROM SURFACE INSPECION (RI) REMOTE-USE OF REMOTE VISUAL EQUIP (BM)BURRIED MH (NA) NO ACCESS (NF) NOT FOUND (NI) HIGH TRAFFIC CANT INSPEC (NO) CAN'T OPEN (SD)SURCHARGED DEBRIS
(A)-PRIMARY MAJOR ROAD (B)-SECONDARY ROADS (C.) LOCAL STREET (D)EASEMENT (E)WOODS (F)
SIDEWALK (G) PARKING LOG (H) ALLEY (I) DITCH (J) BUILDING (K) CREEK (L) RAILWAY (M) AIRPORT (N)
LEVEE/FLOODWALL (O) DAM (P) LEVEE / PUMP STATION (Y) YARD (Z) OTHER
1.SOUND 2.BROKEN 3.CORRODED (PITTED) 4.CRACKED 5.LEAKING 6.POOR INSTALLATION
1.SOUND 2.BROKEN 3.COATED 4.CORRODED (PITTED / WORN) 5.CRACKED 6.MISSING INNERLINE ENGINEERING CITY OF:: HERMOSA BEACH
MANHOLE CONDITION ASSESSMENT FORM
5/30/2017
U-1209-6134
11:12AM MACP LEVEL -1
MH-0825
ROUTINE ASSESSMENT N/A
HERMOSA BEACH
PROSPECT AVE A.SOUZA