2101 Copper Lane - Inspection Form- Sump pumps
Foundation drains
`'F ✓
drains
r� Roof
City of Fall
Residential Sanitary Sewer Service
Compliance Inspection
r
Date 1 �� I V. .�
Name 4 Disk #
{:„%)• -J' em
Time -- 1 6 p
Record Number.
• am
Time i • ▪ o pm
PID Number
House Number. ) . 1 Street Name ��� j Ii ' „'
/ 1
Alternative Mailing Address ` Phone - v L1 := - /
7
For information call 651:470:2788
Compliance
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 ti'% )
inspecti7r Findings .- Number of stacks Entered S Lat `° �('. " ' ' .kr�
Roots / L -7" �-4
Poor Pipe Joints
Mineral Deposits >
Sag /Pipe Deflection
Damaged Pipe
Transition 1,l fj t ,: !' f - %'1 (- 7
4" to 6" Transition:
White Copy: Property Owner
Owner/Occupant Signature
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
Total Correctly
Length of Service:
Number. Discharged
Incorrectly Unknown
Obstruction
Unable to push past
feet
Notes
/ )
Inspect-or Signature
! Final Cleanout:
= 15/00
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Fagan Pink Copy: SEH