4313 Rahn Rd - Inspection Form-'
Number Discharged
Correctly Incorrectly Unknown
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// Note
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Total
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date _ !,
Name'
PID Number
House Number � -+ 1 _ Street Name
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6 "Transition:
White Copy: Property Owner
• $ am
Time pm
fJ Disk #
Ownerlbccupant Signature
Non — Compliance
L !1
�.._ -_.
Record Number 1
Time
Alternative Mailing Address Phone I
Inspector Signature
V :1 am
= D Am
For information call 651.470.2788
Service Lateral Inspection Findings Number of stacks
Roots
Yellow Copy: City of Pagan
Obstruction
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Entered S.L.at _ 1,
No Access
O No one in
O Access to service
lateral needed
0
Inspection
refused
PoorPipeJoints,
Mineral Deposits
Sag /Pipe Deflection__
Damaged Pipe
Transition
A /
r,
r r ;
Length of Service: j , Final Cleanout:
Pink Copy: SEH