4352 Copper Pt - Inspection FormSump pumps
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Foundation drains
Roof drains
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CHI of Ea aft
Residential Sanitary Sewer� Service
Compliance Inspection
Date /, / /
Name
r
Alternative Mailing Address
1 ( iM
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
ti
White Copy: Property Owner
0
A ..._.
f \ f
P °t) r
.c J y am
Time _ i o sob pm
Disk #
Owner /Occupant Signature
PID Number .
House Number _ -0. Street Nam / .._. i" ' : i / -~ r 4—
, -- _
Phone
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
Service Lateral 1 spection Findings Number of stacks
•
Roots
1 1
t l/ Sr
Number Discharged
Total Correctly Incorrectly Unknown
Record Number
Length of Service:
Yellow Copy: City of Eagai
ur
"2• 0, am
Time l / 6 pm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
1 feet
•
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
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Entered S.L. at
IC I- Final Cleanout: 7 # _ 1
Notes
0 i'" >v i
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Pink Copy: SEH