4183 Topaz Dr - Inspection FormSump pumps
"
-
Foundation drains
J; >:
- „_.._
Roof drains
' , - r
--- a�.�.,��
_ ,_..
City of Davao
Residential Sanitary Sewer Service
Compliance Inspection
Date OI( I /C) / te
Name ; .R c'/ (Disk#
9 .
PID Number
House Number 4 Street Name
Alternative MailingAddress
Roots
4" to 6" Transition:
i ipliance
- • No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1. 10,04-6 ] (/( 1/
Ai / A
White Copy: Property Owner
Time !/ • -SC" o prn
Owner /Occupant Signature
Length of Service:
Total Correctly Incorrectly Unknown
/7
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 Discharged
Yellow Copy: City of Eagan
Record Number
Phon
T
/ % i.Frispector Signature
For information call 65
Obstruction
Unable to push past
77, ST feet
I � (pm
Number of stacks / Entered S L at .
4./Ai
Notes
Time
1
/ a
Final Cleanout: J
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
J ra sI/
^ 7 (JrvA � " ( /f t/ r ic(
' 3 4,, 0 t i
Pink Copy: SEH