4721 Pebble Beach Way - Inspection Form
Residential Sanitary Sewer Service
City Eao
I Ir Compliance Inspection
'
Date Time J(~ ~ o prn Record Number,
~
)dame I t Disk# Time ' O pm
f '
PID Number
House Number Street Name
Alternative Mailing Address Phone
Ownerl0ccupont Signature Inspector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
O No foundation drain connection O Clear water connections to Unable to push past O No one in
No roof drain connection sanitary sewer, feet - O Access to service
O Service lateral defects lateral needed
Sump pit not connected to O Defective manholes
' sanitary sewer O Inspection
O Sump pump connected to sanitary refused
Sump pump properly piped sewer
O No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S L at_
Roots
Poor Pipejoints
Mineral Deposits - -
Sag/Pipe Deflection
Damaged Pipe-
Transition
4" to 6 Transition: Length of Service: r? Final Cleanout: e 1
Notes /
Number Discharged
Total Correctly Incorrectly Unknown,
0 PM
Sump pumps)
Foundation drains
Roof drains
White Copy: Ptoperty Owner Yellow Copy: City of Fagan Pink Copy: SEH