1476 Pinetree Pass - Inspection Form1 City of Ewa
Residential Sanitary Sewer Service
Compliance inspection
Date / / r
Name J X L 4t i i ; t om Disk #[— F1_L[j_[___ 1
PID Number I I I
). • ' a
Time / -e - - - " , pm
House Number .--::.?.._Street Name
Alterriagve MailingAddr,ess 1
I
r
•
i
wner107 pant Signature
For information call 651.470/788
Compliance
O No foundation drain connection
O No roof drain connection
l Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to 6 "Transition:
White Copy: Proper ty Owner
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
Number of stacks
Transition
Length of Service:
Record Number
• O em
Time • O pm
Phone
Obstruction
Unable to push past
feet
Entered S L at
Notes
f 7t 1 .�
lnspe'ctor Signature
Final Cleanout:
//
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/
Yellow Copy: City of Eagan Pink Copy: SEH
•
Total
Nunsher
Discharged
Cot reedy
Incorrectly
Unknown
Sump pumps
v .
Foundation drains
Roof drains
/\
1 City of Ewa
Residential Sanitary Sewer Service
Compliance inspection
Date / / r
Name J X L 4t i i ; t om Disk #[— F1_L[j_[___ 1
PID Number I I I
). • ' a
Time / -e - - - " , pm
House Number .--::.?.._Street Name
Alterriagve MailingAddr,ess 1
I
r
•
i
wner107 pant Signature
For information call 651.470/788
Compliance
O No foundation drain connection
O No roof drain connection
l Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to 6 "Transition:
White Copy: Proper ty Owner
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
Number of stacks
Transition
Length of Service:
Record Number
• O em
Time • O pm
Phone
Obstruction
Unable to push past
feet
Entered S L at
Notes
f 7t 1 .�
lnspe'ctor Signature
Final Cleanout:
//
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/
Yellow Copy: City of Eagan Pink Copy: SEH
•