2042 Flint Lane - Inspection FormSump pumps
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Foundation drains
Roof drains
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4111110-
City of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date L5 / ) /1
Name
House Number
Poor PipeJoints
4" to 6" Transition:
PID Number
Alternative Mailing Address
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
White Copy: Property Owner
Time -/
Service Lateral Inspection Fj' dings
Roots
Disk #
Mineral Deposits
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cSag /Pipe Deflection 7
Damaged Pipe
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Transition -- f(
3
- Street Name ) —L L— _ 7714
Phone A-
OwnerlOccupant Signature
For information call 651.470.2788
Total
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
Number of stacks
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet
Entered S L - at ter:
•
•
am
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service:
Number Discharged
Correctly lncorrectly Unknown
Notes
/1
? - � f 1 ,/1 /
, - :< -:_
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- Final Cleanout:
Yellow Copy: City of Eagad'70 - - -47e4;"
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Pink Copy: SEH