Water Service Installation Virtual Inspection Checklist

Public Protection Cabinet Department of
Housing Buildings and Construction
Division of Plumbing
500 Mero St, 1st FI
Frankfort, KY 40601

Water Service Installation Virtual Inspection Checklist
Email of the Journeyman doing Virtual Inspection (for confirmation email):
example@example.com
Journeyman Plumber Signature*

Clear
Journeyman License Number (After "J")*
Date of test*

MonthDayYear
Date
Permit number*
Address of installation*
Type of Construction:*

Single FamilyMulti FamilyCommercial
Specific Location where installed on property*

Front LeftFront CenterFront RightRear LeftRear CenterRear RightOther
Type of material used:*

CopperCPVCPEXPVCPEOther
Minimum eighteen (18) AWG copper tracer wire installed:*

YesNo
Is the Tracer Wire accessible at the meter box?*

YesNo
Is the ending point of the tracer wire above the foundation?*

YesNo
Is the water service 30" deep?*

YesNo
Is there Five (5) foot separation from the sewer:*

YesNo
Is the Water Service and Sewer in the same ditch?*

YesNo
Same ditch installation - Eighteen (18) inches above the top of sewer (LEAVE BLANK IF NOT APPLICABLE):

Yes - 18 inches above top of sewerNo
Water Service placed on solid shelf (LEAVE BLANK IF NOT APPLICABLE)?

YesNo
Joints kept to a minimum:*

YesNo
Was water service properly sleeved or protected: - Example: Crossed sewer or rocks in spoils - (LEAVE BLANK IF NOT APPLICABLE):

YesNo
Sleeve made of proper water service material (LEAVE BLANK IF NOT APPLICABLE):

YesNo
Sleeve sealed on each end (LEAVE BLANK IF NOT APPLICABLE):

YesNo
No physical connection between public and private water (Choose "yes" if there is no connection to a private water source or well):*

YesNo
Office Contact
example@example.com
File Upload

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