1519 Pinetree Tr - Inspection Form4011. al' Fa art
Residential Sanitary Sewer Service
Compliance Inspection
Date I1 r.
House Number
Alternative M ilingAddress
Time
Name 41,0 f ' ! /7, Disk #
PID Number
Owner /Occupant Signature
•� am
• pm
Street Name
i
f
Record Number
Jf
mss, •
Time , •
Phone
inspector Signature
For information call 651.470.2788
Compliance
i No foundation drain connection
No roof drain connection
1
Sump pit not connected to
f
/ sanitary sewer
y , Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition r .._
4" to 6" Transition:
White Copy: Property Owner
Obstruction
Unable to push past
feet.
Number of stacks '2 Entered S.L at
Sump pumps
Foundation drains
Roof drains
Total
j
Correctly Incorrectly Unknown
Number Discharged
Length of Service:
Yellow Copy: City of Pagan
Notes
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f'
Final Cleanout: �`"
Pink Copy: SEH