4112 Nicols Rd - Inspection FormSump pumps
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Foundation drains
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Roof drains
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City of Fagan
Residential Sanitary Sewer Service
Compliance Inspection
Alternative MailingAddress
No sump pump
4" to 6" Transition:
White Copy: Property Owner
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Date/ / ��f Time % S �< pm
Name /t�f - t✓1 = -..F Disk#
PID Number
House Number / 41 -- Street Name ..3
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
P-11(
1,
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Total Correctly
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Incorrectly Unknown
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Non - Compliance
A
fl, Clear water connections to
sanitary sewer I'S r,("f 7. fr / .
Service lateral defects
O Defective manholes
,0..Surnp pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Service:
Number Discharged
Record Number
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(phone 1,
' ft fl ' 1
1 /
Inspector Signature
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1 1r Time • •
For information icall 651.470.2788
Obstruction
Unable to push past
feet
Notes
No Access
O No one in
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L. at # , ACY
Roots 7 f 1 Poor Pipe Pipe Joints
Mineral Deposits '7
Sag /Pipe Deflection 4, / ri
Damaged Pipe / > ( f4.1 Z- ' f` (:: V f r t
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Transition _ ,',,, / :t/ ✓ .. C 41 r Mfr � e: ,
/ r
Final Cleanout:
O Access to service .
lateral needed
Yellow Copy: City of Eagan Pink Copy: SEH