4636 Penkwe Way - Inspection FormCity of Carai
Residential Sanitary Sewer Service
Compliance Inspection
Date • m
Name {%
PID Number
House Number
Compliance
O No foundation drain connection
,.) No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Time
Disk#
OwnerlOccupant Signature
Service Lateral Inspection Findings
Roots
4" to b" Transition:
White Copy: Property Owner
..s(-) am
• o pm
Street Name
Number of stacks
Yellow Copy: City of Fagan
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
Length of Service:
Record Number.
Time
Alternative Mailing Address Phone
•
•
am
. 0 pm
1
- ' ,. - 1 -
Inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S L at.�"
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout: T
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
e' ;/"-h, ' ! - f ? J f l = r , r
"
�, {
? . r - f 1 , C.
Total
Sump pumps
. % r { i O 4.
.. - /
;. -?
`t
Foundation drains
--
/
drains
: El= Roof
City of Carai
Residential Sanitary Sewer Service
Compliance Inspection
Date • m
Name {%
PID Number
House Number
Compliance
O No foundation drain connection
,.) No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Time
Disk#
OwnerlOccupant Signature
Service Lateral Inspection Findings
Roots
4" to b" Transition:
White Copy: Property Owner
..s(-) am
• o pm
Street Name
Number of stacks
Yellow Copy: City of Fagan
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
Length of Service:
Record Number.
Time
Alternative Mailing Address Phone
•
•
am
. 0 pm
1
- ' ,. - 1 -
Inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S L at.�"
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout: T
Pink Copy: SEH