3675 Windtree Cir - Inspection FormCitl of likao
Residential Sanitary Sewer Service
Compliance Inspection
Dater--;
Time
Disk #
PID Number
House Number P.r-:s ..` 7 Street Name
n
Alternative Mailing Address Phones
:lya .4 i i2
Owner /Occupant Signature
Compliance
®No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4” to 6" Transition:
White Copy: Propetty;Ownet
f am
/ pm
For information call 651 .470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
LOJ Defective manholes
far Sump pump connected to sanitary
/
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged,Pipe
Transition
Length of Service:
Record Number �f
ime �" pm
lnspector'Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f . r
Final Cleanout:
Pink Copy: SEH
}
Number
Correctly
Discharged
Incorrectly Unknown .
Notes
f � i
s
C .. 1 / 1„
.a ` • l T 'l .- War s
_i - ,,s , . ,, L „ . J
— n - J r `t, 7 .-- > . � ",
Total
Sump pumps
s
�'°
Foundation drains
"�
f f
MI
Roof drains '
, -/ f
-
v r ) y 4, ° �, .: �, ' �--"'"''' .
Citl of likao
Residential Sanitary Sewer Service
Compliance Inspection
Dater--;
Time
Disk #
PID Number
House Number P.r-:s ..` 7 Street Name
n
Alternative Mailing Address Phones
:lya .4 i i2
Owner /Occupant Signature
Compliance
®No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4” to 6" Transition:
White Copy: Propetty;Ownet
f am
/ pm
For information call 651 .470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
LOJ Defective manholes
far Sump pump connected to sanitary
/
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged,Pipe
Transition
Length of Service:
Record Number �f
ime �" pm
lnspector'Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f . r
Final Cleanout:
Pink Copy: SEH
}