2025 Zircon Lane - Inspection FormResiclential Sanitary Sewer Service
Compliance Inspection
) Date ) / /
Name
Transition ("4-
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
,
PID Number
/2 (2
House Number Street Name
Alternative Mailing Address
7.
Owner/Occupant Signature
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
Li A
Total
White Copy: Pi oper ty Owner
ani
Time pm
Disk #
1
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
Correctly
Length of Service. ?„,i,""/
Number Discharged
incorrectly
Unknown
Record Number
7 ,- - ) . • am
Time ) o pm
/1
/3/ ,•<
Phone 7;: 5 ) - '7 1 ° 2 -(1 , -777
For information call 651.470.2788
Obstruction
Una push past
feet
777
Inspector Signature
Final Cleanout:
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Service Lateral inspection Findings Number of stacks
Entered SL .at )
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Notes
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Yellow Copy: City of Eagar0 r-/ Pink Copy: Sal