3753 Windtree Dr - Inspection FormlilyoEgo
Residential Sanitary Sewer Service
Compliance Inspection
Date (21"/ — / /(.)
Name
PID Number
Alternative Mailing Address
A
1
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Disk #
Service Lateral Inspection Findings
Roots
Transition
4" to 6 "Transition:
White Copy: Property Owner
E
kibk
Time ft 'o
dam
O pm
Number of stacks
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
r•�
I�LJ -[1J
House Number ! r Street Name _ G`
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
Length of Service:
Yellow Copy: City of Fagan
Record Number
ii
Obstruction
Unable to push past
feet
77
Phdne_ «2' 77
/7 f .
For information call 651;:470.2788
Entered S.L. at -r-. ?;-( t
Poor Pipe Joints
Time
Jnfpector Signature
p' am
✓� 0 p
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: r�rrt/
Pink Copy: SEH
Number
Correctly
Discharged.. - .
Incorrectly Unknown
Notes r- -(tf� t j.'r✓ /�u,- ,lr, - r-)
' f 4, ,. , _ ; f
' 1- c
ter -- � a ft�;i /
_ d
,tf�.... , ;, —, :✓ -7 ✓' l�f/7 (:/' r
� /�� i fG� ✓ .
Total
Sump pumps
�-
_ .___
__� _._ .
._.
Foundation drains
�.
Roof drains
_._.
�._. . _ ._�
lilyoEgo
Residential Sanitary Sewer Service
Compliance Inspection
Date (21"/ — / /(.)
Name
PID Number
Alternative Mailing Address
A
1
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Disk #
Service Lateral Inspection Findings
Roots
Transition
4" to 6 "Transition:
White Copy: Property Owner
E
kibk
Time ft 'o
dam
O pm
Number of stacks
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
r•�
I�LJ -[1J
House Number ! r Street Name _ G`
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
Length of Service:
Yellow Copy: City of Fagan
Record Number
ii
Obstruction
Unable to push past
feet
77
Phdne_ «2' 77
/7 f .
For information call 651;:470.2788
Entered S.L. at -r-. ?;-( t
Poor Pipe Joints
Time
Jnfpector Signature
p' am
✓� 0 p
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: r�rrt/
Pink Copy: SEH