ends for distance of 10' from sewer in both directions provided. Excavation and backfill procedures meet specification requirements. Piping bedding and backfill materials meet specification requirements. Underground warning tape installed 6"-12" below finished grade above all exterior below ground piping. Non-metallic piping has tracer wire installed per Wisconsin Administrative Plumbing Codes. Negative Responses Date Found Date Found By Location Reason for Negative Response Resolved Resolved Resolution YES / NO YES / NO YES / NO YES / NO YES / NO D) TESTING & FINALIZATION CHECKS % Questions (See details below) Date Description of Work Performed Complete Initials 1) 2) 3) 4) 5) 6) 7) 8) YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO
ends for distance of 10' from sewer in both directions provided. Excavation and backfill procedures meet specification requirements. Piping bedding and backfill materials meet specification requirements. Underground warning tape installed 6"-12" below finished grade above all exterior below ground piping. Non-metallic piping has tracer wire installed per Wisconsin Administrative Plumbing Codes. Negative Responses Date Found Found By Location Reason for Negative Response Resolved Date Resolved Resolution YES / NO YES / NO YES / NO YES / NO YES / NO D) TESTING & FINALIZATION CHECKS Date Description of Work Performed % Complete Initials Questions (See details below) 1) 2) 3) 4) 5) 6) 7) 8) YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO
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