2054 Bluestone Dr E - Inspection Form'
Cityortaga
Residential Sanitary Sewer Service
Compliance Inspection
Datell
Pi Name �n ( Disk # 3 1 -
PID Number
House Number ` - 7 - Street Name
Alternative Mailing Address
/
. i i, .
No sump pump
Poor Pipe Joints
Mineral Deposits
( S glPipe Deflection
Damaged Pipe
} ri
Transition �
4" to 6 "Transition:
White Copy: Property Owner
• v0 O>am
Time. •
OwnerlOccupant 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
Service Lateral Inspection Findin
Roots e .
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
Pm
s (I Number of stacks
i 1 f
Length of Service:
Yellow Copy: City of Fagan
Record Number
Obstruction
Unable to push past
feet
Entered S. L. at
57,
r4
i.— Ajam
T ime - a Pm
Phone . 1 - f j f
+ 1
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
•
Final Cleanout:
•
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
,z Fi
Total
Sump pumps
r ,,
Foundation drains
,
Roof drains
'
Cityortaga
Residential Sanitary Sewer Service
Compliance Inspection
Datell
Pi Name �n ( Disk # 3 1 -
PID Number
House Number ` - 7 - Street Name
Alternative Mailing Address
/
. i i, .
No sump pump
Poor Pipe Joints
Mineral Deposits
( S glPipe Deflection
Damaged Pipe
} ri
Transition �
4" to 6 "Transition:
White Copy: Property Owner
• v0 O>am
Time. •
OwnerlOccupant 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
Service Lateral Inspection Findin
Roots e .
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
Pm
s (I Number of stacks
i 1 f
Length of Service:
Yellow Copy: City of Fagan
Record Number
Obstruction
Unable to push past
feet
Entered S. L. at
57,
r4
i.— Ajam
T ime - a Pm
Phone . 1 - f j f
+ 1
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
•
Final Cleanout:
•
Pink Copy: SEH