1373 Grace Dr - Inspection FormCity of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
ii? 1 ) )•
Date / i 1 l(� 1 I Time "7 .
Name l f'z� Disk # ��
PO Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
iv Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
am
pm
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Fagan
Record Number
Time
Ph oneme — r)
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
T
O am
O pm
f
f Jul Gf.1 t
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
Pink Copy: SEH
Total
N otes
i
i �'
% . - J, -
�_ - !
:
)
1
v _.. -;�
f
�- A ---, " " -
� 1
, . E .
r',"
-' ` , L
r
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
J'r
} ,✓�
_ i
Foundation drains
Roof drains
— )
City of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
ii? 1 ) )•
Date / i 1 l(� 1 I Time "7 .
Name l f'z� Disk # ��
PO Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Owner
Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
iv Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
am
pm
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Yellow Copy: City of Fagan
Record Number
Time
Ph oneme — r)
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
•
•
Final Cleanout:
T
O am
O pm
f
f Jul Gf.1 t
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
Pink Copy: SEH