4190 Diamond Dr - Inspection FormCity of Fain
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name ¢°i r r'� L•✓ =£ Disk #
ND Number z�
House Number
Alternative Mailing Address
Sag /Pipe Deflection
4" to 6 " Transition: /
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
;'pNo sump pump
l✓.
White Copy: Property Owner
7 • e eem
Time ( I • 1',( O pm
/ y T
Street Name
Non - Compliance
0
O
O
0
0
'
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Service Lateral Inspection Findings Number of stacks Entered S Lat.
Roots -. fr� t 3 � � ... i
. f
Poor Pipe Joints
Mineral Deposits
Damaged Pipe.
Transition
b am
•
Time '' ? • 1
• / o pm
Phone . i j ` C--)
;'Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: Final Cleanout:
Notes
t ` {t • ' r `
/
" 1
Yellow Copy: City of Fagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
(;)----.
__
Foundation drains
,1 '
��
Roof drains
- -
- - ----
City of Fain
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name ¢°i r r'� L•✓ =£ Disk #
ND Number z�
House Number
Alternative Mailing Address
Sag /Pipe Deflection
4" to 6 " Transition: /
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
;'pNo sump pump
l✓.
White Copy: Property Owner
7 • e eem
Time ( I • 1',( O pm
/ y T
Street Name
Non - Compliance
0
O
O
0
0
'
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Record Number
Service Lateral Inspection Findings Number of stacks Entered S Lat.
Roots -. fr� t 3 � � ... i
. f
Poor Pipe Joints
Mineral Deposits
Damaged Pipe.
Transition
b am
•
Time '' ? • 1
• / o pm
Phone . i j ` C--)
;'Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: Final Cleanout:
Notes
t ` {t • ' r `
/
" 1
Yellow Copy: City of Fagan Pink Copy: SEH