2114 Quartz Lane - Inspection FormCity DI Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date eV / 4 I /
Name
Compliance
O No foundation drain connection
k No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
k r No sump pump
White Copy: Property Owner
• O anl
Time • o pm
er Disk #
PID Number
Alternative Mailing Address .
/ Y 6 i
Owrier/Occupart Signature
0
7
LLJ
LE
9
House Numbe Street Name r
&V 07 - 7_57C
Pheine . .
/
(„
V Inspector Signature
For information call 651.470.2788
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks I
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition: V }9 4ength of Service:
7
Yellow Copy: City of Fagan
Record Number
0 ? • , 7 1 arn
Time • 0 pm
Entered Si_ at
/7
A
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
.. Number
Correctly
Discharged : .
Notes - vi t.lov., L,,,,,t/
7 ..' -
a J tl --- r 1'f -i-( .- ,,-( C
i ..... _
-2-1 - IW 1 •.-C
- •
S 'o , A,,
i ' J
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
„--___
City DI Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Date eV / 4 I /
Name
Compliance
O No foundation drain connection
k No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
k r No sump pump
White Copy: Property Owner
• O anl
Time • o pm
er Disk #
PID Number
Alternative Mailing Address .
/ Y 6 i
Owrier/Occupart Signature
0
7
LLJ
LE
9
House Numbe Street Name r
&V 07 - 7_57C
Pheine . .
/
(„
V Inspector Signature
For information call 651.470.2788
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks I
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition: V }9 4ength of Service:
7
Yellow Copy: City of Fagan
Record Number
0 ? • , 7 1 arn
Time • 0 pm
Entered Si_ at
/7
A
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH