2015 Zircon Lane - Inspection Formimpr. Residenti Sanitary Sewer Service
• •
City ol taga1 Compliance Inspection
Date / 2'''"7 /c
Name /7440 14.C1/7"7 Disk #
PID Number
House Number 2 0
Alternative Mailing Address
White Copy: Pr operty Owner
Time
Owner/Occupant Signature
Compliance
0 No foundation drain connection
k.,O' No roof drain connection
1 Sump pit not connected to
v sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots 4
Lz(-arn
0 P m
Poor PipeJoints
Mineral Deposits 7 5
Sag/Pipe Deflection
Damaged Pipe
Transition
Street Name z jg Co"
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
Number of stacks
1, —
4" to 6" Tr ansition: (Uri Length of Service:
Phone tfr//,/} e/57:9
/
/!-7
(111 Signature
(
Record Number 1
1,1
KAlouf
Time
Obstruction
Unable to push past
feet
o P •
•
/—'
No Access
O No one in
Entered S L at )1/
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Notes (
• 4
. / •
• - 1
- a
— •
'45
- (-66100
Yellow Copy: City of Ea Pink Copy: SEFi
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
f 1
Foundation drains
Roof drains
impr. Residenti Sanitary Sewer Service
• •
City ol taga1 Compliance Inspection
Date / 2'''"7 /c
Name /7440 14.C1/7"7 Disk #
PID Number
House Number 2 0
Alternative Mailing Address
White Copy: Pr operty Owner
Time
Owner/Occupant Signature
Compliance
0 No foundation drain connection
k.,O' No roof drain connection
1 Sump pit not connected to
v sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots 4
Lz(-arn
0 P m
Poor PipeJoints
Mineral Deposits 7 5
Sag/Pipe Deflection
Damaged Pipe
Transition
Street Name z jg Co"
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
Number of stacks
1, —
4" to 6" Tr ansition: (Uri Length of Service:
Phone tfr//,/} e/57:9
/
/!-7
(111 Signature
(
Record Number 1
1,1
KAlouf
Time
Obstruction
Unable to push past
feet
o P •
•
/—'
No Access
O No one in
Entered S L at )1/
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Notes (
• 4
. / •
• - 1
- a
— •
'45
- (-66100
Yellow Copy: City of Ea Pink Copy: SEFi