4358 Copper Pt - Inspection FormSump pumps
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Foundation drains
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Roof drains
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2
City of bpi
Residential Sanitary Sewer Service
Compliance Inspection
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Date 1 m( ;1 Tl J Time ) • p
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Name Y� f Disk#
PID Number
House Number
pliance
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
Damaged Pipe
Transition 2-1--
4" to 6" Transition:
White Copy: Property Owner
Street Name
OwnerlOccupant Signature
Total
Length of Service:
Number Discharged
Correctiy Incorrectly Unknown
Yellow Copy: City of Fagan
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
Record Number
Time
/
Alternative MailingAddress Phone r
Inspector Signature
For information call 651 .470.2788
Obstruction
Unable to push past
feet
Entered S L at
Roots
Poor Pipejoints
Mineral Deposits /
▪ Sag/pipe Deflection 1'
Notes
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Pm
�
),- Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH