Sewer Video Inspection Report | Form

2–4 high-resolution stills of the most critical defects found. 6. Sign-off Technician Signature: Confirms accuracy of the field data.

Name of the operator performing the CCTV scan. Sewer Video Inspection Report Form

(e.g., PVC, Clay, Cast Iron, Concrete, Orangeburg). Pipe Diameter: (e.g., 4", 6", 8"). Pipe Length: Total distance surveyed. Direction of Survey: (e.g., With Flow / Against Flow). 2–4 high-resolution stills of the most critical defects

(e.g., Cleanout, Roof Vent, Manhole, Toilet pull). 3. Inspection Observations (The Log) Orangeburg). Pipe Diameter: (e.g.

General status (e.g., Excellent, Fair, Poor). Action Required: No action needed. Schedule cleaning/hydro-jetting. Spot repair required. Full lining or replacement recommended.

Signature to confirm receipt of the report.

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