2050 Carnelian Lane - Inspection FormCity of Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Dated 4/ �r
Name/ . 0 1r,41-C
PID Number
House Number
Alternative Mailing Address
1 '
Compliance
Lt
4" to 6" Transition:
White Copy: Property Owner
Street Name
Disk #
Owner /Occupant Signature
No foundation drain connection
j No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
No sump pump
0)109 am
Time L( /O O pm
[121
For information :call 65I.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 Findings Number of stacks
Roots `- l
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe i
Transition 1 f ?/ 4 - L � j ° _ J ,
Length of Service: 4.,4 1 L_
Yellow Copy; City of Pagan
Record Number
Phone _ f-rj5j
am
Time / • pm
Obstruction
Unable to push past
feet.
Entered S. L at •
o�F�r
▪ S
�U ma
� - �� „�,;;, �.�.-- ..� -.-.
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
J
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
`'
Foundation drains
7
Roof drains
.
City of Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Dated 4/ �r
Name/ . 0 1r,41-C
PID Number
House Number
Alternative Mailing Address
1 '
Compliance
Lt
4" to 6" Transition:
White Copy: Property Owner
Street Name
Disk #
Owner /Occupant Signature
No foundation drain connection
j No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
No sump pump
0)109 am
Time L( /O O pm
[121
For information :call 65I.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 Findings Number of stacks
Roots `- l
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe i
Transition 1 f ?/ 4 - L � j ° _ J ,
Length of Service: 4.,4 1 L_
Yellow Copy; City of Pagan
Record Number
Phone _ f-rj5j
am
Time / • pm
Obstruction
Unable to push past
feet.
Entered S. L at •
o�F�r
▪ S
�U ma
� - �� „�,;;, �.�.-- ..� -.-.
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
J