HomeMy WebLinkAboutPoint of Sale Compliance Inspection Form`tsHQ�'„�
___F44YL Date Called in - 3-
r Date Scheduled
City Of Orono
Point of Sale Sanitary Sewer Service I&I Compliance Inspection Form
Property Address:
1 , 4 S C -V rt_e�t
PID:
-1-a3-1 -
Owner Information
Name:
Wi,::Y, 3� C
Mailing Address:
(if different from
Property)
S � SS„ C.+.
Phone:
I Iola. 910Ag-12Email: I h. b c 0— me K&i . C oyin
Ins .,ctor Information
Name: f f
C mpany/ Orga •zation
License number:
Fail
Phone:
Email:
Name
%IMM"WaRm'
Inspection
System
Standard
Pass
Fail
Roof Drains
Roof drains and leaders Roof drains should not be connected to the sanitary
Name
sewer but should discharge to the ground outside of a building. If the roof
drains are connected to the sanitary sewer, disconnect them, plug any open
connections to the sanitary sewer using anon -shrink permanent material, and
redirect the roof drains onto the ground outside the building.
Foundation
Foundation drains are underground pipes that collect storm water from
Drains
around the base of a building and into a sump basket, where it is then
X
pumped outside of the building. Foundation drains should not be connected
to the sanitary sewer.
Sump Pumps
Sump pumps are designed to capture surface or ground water that enters
basements or crawl spaces and pump it away from the house. The basic sump
system includes drain tile, a sump pit, a sump purnp, a float or switch, and a
drain line. Sump pumps should not be connected to the sanitary sewer.
Sewer Service
Sanitary Sewer Inflow & Infiltration (III) Compliance Inspection Sanitary
Line
Sewer Lines. All sanitary sewer lines serving Property, from the house to the
main line, shall be in a safe and finrctional condition and shall be free from all
leaks, failures including but not limited to partially collapsed sections or tree
root intrusion. The sanitary sewer lines shall meet the City Code standards and
specifications. Details on back of this sheet)
Notes:
+ *3
13c, t 41
City Review
Inspectors Signature:
Date: -n--;41
Owners signature:
I Date:
City Review
El Compliant
,.-X, Corrective Action Required
Certificate of Compliance Expires:
Corrective Action Due by:
Date:
Signature:
Name
Service Line Inspection Details
Weather Conditions:
Approximate Depth of Service
Type and Size of Service
Overall Condition of Service Pipe
Please note all connections, fittings, points of concern on service line including infiltration, tree root,
cracks, misaligned joints, etc.
This report must include a digital copy of the televising.
Feet
Comment
Example:
0
Start for 4" cleanout in NE corner of Basement
1-10
Misaligned joint —Infiltration
0
Notes:
Date Called in
Date Scheduled
City Of Orono
Point of Sale \\ASIIOP�C/ Sanitary Sewer Service I&I Compliance Inspection Form
Property Address:
3 q
PID:
I 06 - E - -- -
Owner Information
Name:
H&Mi
Mailing Address:
(if different from
Property)
Fail
Phone:
- $ p - Email:
Inspector Information
Name:
Company/ Organization License number:
Phone: Email:
Inspection
System
Standard
Pass
Fail
Roof Drains
Roof drains and leaders Roof drains should not be connected to the sanitary
Name: �7 �-
sewer but should discharge to the ground outside of a building. If the roof
drains are connected to the sanitary sewer, disconnect them, plug any open
y
connections to the sanitary sewer using a non -shrink permanent material, and
n
redirect the roof drains onto the ground outside the building.
Foundation
Foundation drains su•e underground pipes that collect storm water from
Drains
around the base of a building and into a sump basket, where it is then
pumped outside of the building. Foundation drains should not be connected
to the sanitary sewer.
Sump Pumps
Sump pumps are designed to capture surface or ground water that enters
basements or crawl spaces and pump it away from the house. The basic sump
system includes drain tile, a sump pit, a sump pump, a float or switch, and a
drain line. Sump pumps should not be connected to the sanitary sewer.
Sewer Service
Sanitary Sewer Inflow & Infiltration (I/I) Compliance Inspection Sanitary
Line
Sewer Lines. All sanitary sewer lines serving Property, from the house to the
main line, shall be in a safe and functional condition and shall be free from all
leaks, failures including but not limited to partially collapsed sections or tree
root intrusion. The sanitary sewer lines shall meet the City Code standards and
specifications. (Details on back of this sheet)
Notes:'
CQrrKCted m�
CitVYReview
Inspectors Signature: {' j
Date: - ()
Owners signature:
Date:
CitVYReview
Compliant
1 ❑ Corrective Action Required
Certificate of Compliance Expires:
Corrective Action Due b
Date:
Si nature:
Name: �7 �-
Service Line Inspection Details
Weather Conditions:
Approximate Depth of Service
Type and Size of Service
Overall Condition of Service Pipe
Please note all connections, fittings, points of concern on service line including infiltration, tree root,
cracks, misaligned joints, etc.
This report must include a digital copy of the televising.
Feet
Comment
Example:
0
Start for 4" cleanout in NE corner of Basement
1-10
Misaligned joint —Infiltration
0
Notes:
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