2090 Coral Lane - Inspection FormCity of . aaa
Residential Sanitary Sewer Service
Corripliance Inspection
Date 71 )
r '
Name ).1
House Number
Com pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
t0{ Sump pump properly piped
C} No sump pump
/ 2
Disk
Time
PID Number
.�' Street Name
Alternative Mailing Address
Owner /Occupant 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
Service Lateral Inspection Fin 1iyigs Number of stacks
Roots i°
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
'iL/ Q� am
- — f Sb pm
Length of Service: �1
Record Number
Phone . - JILL
Inspector Signature
Obstruction
Unable to push past
feet
Entered S•L.
Notes
1
rr���
• C� O am
_ Pm
`7"
-- Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
!
Yellow Copy: City of Fagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
{` .
Roof drains
l)
City of . aaa
Residential Sanitary Sewer Service
Corripliance Inspection
Date 71 )
r '
Name ).1
House Number
Com pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
t0{ Sump pump properly piped
C} No sump pump
/ 2
Disk
Time
PID Number
.�' Street Name
Alternative Mailing Address
Owner /Occupant 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
Service Lateral Inspection Fin 1iyigs Number of stacks
Roots i°
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
'iL/ Q� am
- — f Sb pm
Length of Service: �1
Record Number
Phone . - JILL
Inspector Signature
Obstruction
Unable to push past
feet
Entered S•L.
Notes
1
rr���
• C� O am
_ Pm
`7"
-- Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
!
Yellow Copy: City of Fagan Pink Copy: SEH