1646 Covington Lane - Inspection FormCity of Ea dO
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date i � /
Name e
PID Number
House Number I
Alternative,.Mailing Address
/
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
61 No roof drain connection
�Sump pit not connected to
/ sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Proper ty Owner
r" JOojam
Time, • j pm
Disk #
Street Name
▪ L ) :r
4„..)
Phone - T , rv.- '0
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Fagan
Record Number
Time
Obstruction
• O am
• O pm
•
Inspector Signature
Unable to push past 0 No one in
feet
Entered S L,at
Final Cleanout:
}
Jai )'x.46 v
,
No Access
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
r TM.
E� � e / ,' � � `r `t
:Pr 4 - °`" `"
i ) 1 ---j ,----
J . =�, � / /1 ` e- P / ; "_7 -./
1
Total
Sump pumps
.,� .-.
— �` -)
_ • J
h
Foundation drains
Roof drains
City of Ea dO
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date i � /
Name e
PID Number
House Number I
Alternative,.Mailing Address
/
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
61 No roof drain connection
�Sump pit not connected to
/ sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Proper ty Owner
r" JOojam
Time, • j pm
Disk #
Street Name
▪ L ) :r
4„..)
Phone - T , rv.- '0
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Fagan
Record Number
Time
Obstruction
• O am
• O pm
•
Inspector Signature
Unable to push past 0 No one in
feet
Entered S L,at
Final Cleanout:
}
Jai )'x.46 v
,
No Access
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH