830 Ivy Lane - Inspection FormGay of Eapa
Residential Sanitary Sewer Service
Compliance Inspection
Date 0J1 Z
Name
7,7744vS Disk#
Oani
Time /Z:
PID Number ,r
House Number
Street Name
0
3
„---
/
Alternative Mailing Address Phone (0 (—)
fr4ector Signature
//
OwnerlOcca Signature
For information call 651.470.2788
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
Compliance
C O' No foundation drain connection
O No roof drain connection
[6, Sump pit not connected to
/ sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks 1 Entered S.L at
Roots /6 7/Af cl* T -;
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
/J - gic
4" to 6" Transition: A ,
, 4 /";-
__2
Length of Service: j
White Copy: Property Owner Yellow Copy: City of Fagan
6 dv
,/7
Z
Record Number
IJ
Obstruction
Unable to push past
feet
Zft_57,--
/
Z • 7 0 am
Time • 4
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
- 1
Final Cleanout:
Pink Copy: SEH
r
Total
-,)
Notes-ljAMv (f,: c 7 r
4 . , / i
, ii: L
i , '.c
= A (
....... (ft' :r
1 "
17/9056zr vccr)
., ,-
!..,,w,0,...././1/ ;: --- `-
/- -
f fli,./ /:-)4,,..4-L_ (::::: 7,
(Ft 6. 7 -...-----,?) \
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
.
Foundation drains
Roof drains
Gay of Eapa
Residential Sanitary Sewer Service
Compliance Inspection
Date 0J1 Z
Name
7,7744vS Disk#
Oani
Time /Z:
PID Number ,r
House Number
Street Name
0
3
„---
/
Alternative Mailing Address Phone (0 (—)
fr4ector Signature
//
OwnerlOcca Signature
For information call 651.470.2788
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
Compliance
C O' No foundation drain connection
O No roof drain connection
[6, Sump pit not connected to
/ sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings Number of stacks 1 Entered S.L at
Roots /6 7/Af cl* T -;
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
/J - gic
4" to 6" Transition: A ,
, 4 /";-
__2
Length of Service: j
White Copy: Property Owner Yellow Copy: City of Fagan
6 dv
,/7
Z
Record Number
IJ
Obstruction
Unable to push past
feet
Zft_57,--
/
Z • 7 0 am
Time • 4
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
- 1
Final Cleanout:
Pink Copy: SEH
r