2050 Copper Lane - Inspection FormSump pumps
0
Foundation drains
0
Roof drains
,)
City or
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 l 13 /
Name PAM i t-A F-R-D Disk #
PID Number
House Number Street Name
Alternative Mailing Address
4" to 6 "Transition:
White Copy: Property Owner
Time 1 •0O oam
• "fypm
OwnerlQccupant Signature
Compliance
No foundation drain connection
( i , No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
0, No sump pump
Total
LAI
For information call 651:470:2788
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 Inspection Findings Number of stacks
Roots 5 c.< ° ' `( ()5, t
l. .
Poor Pipejoints I ,
Mineral Deposits
Sag /Pipe Deflection
Cb p t\
Damaged Pipe
Transition
Length of Service:
Number Discharged
Correctly Incorrectly Unknown
Record Number
Phone
664
2
•
r C.
; O am
Time i -• ) 'pm
- 2 Li _1,3
Obstruction
Unable to push past
feet..
Inspector Signature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Entered (i - tc 5 k C :r.',
Final Cleanout: f .
Notes
' . L c.) r.) `, (Z
Yellow Copy: City of Fagan Pink Copy: SEH