2022 Diffley Rd - Inspection Formviog()\
City or Ea ap
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name ,
PID Number
House Number
Alternative Mailing Address
// Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
L
Owner/Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Finds Number of stacks Entered S L,at
Roots
r - i
Poor Pipe Joints
Mineral Deposits r'
1 < .
� rt
a✓ tiY am
Time •_ I a Pm
Disk #
Street Name
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
Yellow Copy: City of Fagan
Record Number
Time
Obstruction
Unable to push past
feet
r _
•
Inspector Signature
7)
(,)
am
Pm
2
Phone
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: /-°` _fin Cleanout:
-
Pink Copy: SEH
Number Discharged
Notes
Total
Correctly
Incorrectly Unknown
Sump pumps
X
Foundation drains
Roof drains
(
viog()\
City or Ea ap
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name ,
PID Number
House Number
Alternative Mailing Address
// Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
L
Owner/Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Finds Number of stacks Entered S L,at
Roots
r - i
Poor Pipe Joints
Mineral Deposits r'
1 < .
� rt
a✓ tiY am
Time •_ I a Pm
Disk #
Street Name
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
Yellow Copy: City of Fagan
Record Number
Time
Obstruction
Unable to push past
feet
r _
•
Inspector Signature
7)
(,)
am
Pm
2
Phone
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Length of Service: /-°` _fin Cleanout:
-
Pink Copy: SEH