HomeMy WebLinkAboutDrain Layers Permit 19 Spinners Run TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: 6L ,z 3
BUILDING ADDRESSOR LOT N° :
STREET:
SUBDIVISION: n."h h 'e.- s L ,4r )pS
0
IVH STATION : +
NORTH ARROW INVERT ELEV: -
op
TIE ' Q; " TIE � •
—FT
/0 FT.
HOUSE LATERAL LAT RAL HOUSE
CONNECTION J STUB yrujo r CONNECTION
FT. o f �• FT.
BUILDING INV. ELEV. INV.ELEV. / INV. ELEV. INV. ELEV,
(IF EXIST.) ( G�oa�€� BUILDING(IF EXIST.)
TIE / TIE
t Mi STATION : +
INVERT ELEV:
YNoil7- �P s r
ONTRACTOR (PRINT) / NAME OF CONTRACTORS SUPERVISOR(PRINT)
hr /9 cXY
/STREET ADDRESS SIGNA E DATE
rAll)A01-
TOWN STATE ZIP INSPECTED BY TOWN DATE
Sao ev o sue"
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW -CONSULTING ENGINEER/DEVELOPER
TOWN OF SOUTH WINDSOR
SANITARY SEWER INSPECTION CHECKLIST
FUNCTION jCy �h 4 NO YES N/A DATE INSPECTED
1. Is Permit On Job Si e
2. Police Notified
3 . Safety Items In Place
a. Shoring, Trench Box, Ladder
b. Hard Hats
C. Pumps
4 . Proper Material
a. Pipe
b. Pipe Bedding =�
c. Backfill
d. Warning Tape
e. Pipe Cap or Plug t�
f . Cleanouts
g. Fittings
h. Manhole
i. Cover & Frame
5. Existing Lateral Cap Removed
in Presence of Inspector
6 . Lateral probed and found
to be clear V
7 . Pavement Cut Properly
8 . Trench & Bedding OR
9 . Joints Properly Done
10 . Backfilling (12" Lifts)
& Compaction
11. Manhole Inverts Built
12. Subbase Material Placed
13 . Base Material Placed
14. Blacktop (Temp) w/Proper
Grades & Slopes
15. Pressure Test
16 . Mandrel Test
17 . Installation agrees with plan
18 . As-Built plans recorded