4689 Kingsbury Dr - Inspection FormSump pumps
A
/
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Foundation drains
Roof drains
41 City of Faai
Residential Sanitary Sewer Service
Compliance Inspection
," • 0 am
Time,
P
Date kiL&I ,)(2
-
Name VI Disk #
)
PID Number
House Number Street Name
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant Signature
Compliance
0 No foundation drain connection
Ow No roof drain connection
0 Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral inspection Findings
— • /
Non-Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective rnanholes
O Sump pump connected to sanitary
sewer
O flexible sump pump piping
Number of stacks
Length of Service:
Number Discharged
Total Correctly
ncor rectly
Unknown
Record Number
Notes
?7)
17/
Obstruction
Unable to push past
feet
Final Cleanout:
0 am
•
Time • 0 P m
,-,,,,,--__-,----.-_-,..„-------- -----:.---
inspector Signature \),„..--? s . ,//),„7":7"
..,, . t..._- -' ' • '
1 \ A , A
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of F agan Pink Copy: SEH