Sanitary Sewer Inspection Form

Property number *

Street name *

City *

State *

ZIP *

E‐mail Address *

Phone number *

Block and Lot

Other *

Sanitary Sewer Certification

Does the property have public sewer? *YesNo

Roof drains discharge into sanitary sewer *YesNo

Foundation drain discharges into sanitary sewer *YesNo

Storm / ground water sump pump discharges to sanitary sewer *YesNo

Combination storm / sanitary pump discharges to sanitary sewer *YesNo

I do hereby certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willingly false, I will be subject to penalty.

Signature *Please enter your full name to sign

Printed Name *

Borough of High Bridge

Sanitary Sewer Inspection Form

Sanitary Sewer Certification