4653 Penkwe Way - Inspection Formit or Ea
pa
p
Residential Sanitary Sewer Service
Compliance Inspection
•
DateI1 Time
Name O. - Disk #
PID Number
1 1
House Number Street Name
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
White Copy: Proper ty Owner
0 ner /Occupant Signature
f. }? Transition T i
31
f7 rte'
)(.4
4" to 6" Transition:
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
p
41 pm
_
Yellow Copy: City of Fagan
Record Number
T1' Time
Phone s L.,?-0551-,-e?q-c14
Inspector' gnature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L. at � —
Roots
-2 /1
'1
rl
1
o am
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
inal Cleanout: - r
Pink Copy: SEH
Total
Notes
/�
6/( 7 4 , Q4
J..
!°�'7� % y l :: i ce
/ '!'1) L0. ) / /L)C-7
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
! /,
jJ iy i }
(�
Foundation drains
/7
Roof drains
it or Ea
pa
p
Residential Sanitary Sewer Service
Compliance Inspection
•
DateI1 Time
Name O. - Disk #
PID Number
1 1
House Number Street Name
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
White Copy: Proper ty Owner
0 ner /Occupant Signature
f. }? Transition T i
31
f7 rte'
)(.4
4" to 6" Transition:
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
p
41 pm
_
Yellow Copy: City of Fagan
Record Number
T1' Time
Phone s L.,?-0551-,-e?q-c14
Inspector' gnature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L. at � —
Roots
-2 /1
'1
rl
1
o am
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
inal Cleanout: - r
Pink Copy: SEH