1306 St Andrew Blvd - Inspection Form41 oI Capri
Residential Sanitary Sewer Service
Compliance Inspection
Date. / 3 I / } --),' Time
Name / • - , f Disk #
PID Number
House Number
Alternative
r
4" to 6" Transition:
White Copy: Property Owner
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Ser vice Lateral Inspection Findings
Street Name
g am
pm
Address
0 nerl0ccupant Signature
Non - Compliance
Length of Service:
Yellow Copy: City of Eagan
Record Number 4
• ? O'
Time • /d pm
•
99 eC� '"
Phone F � I "�.�- _ �
Inspector Signature
For information calf 651.47 0.2788
Obstruction
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks Entered S L. at <=
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor. Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged.
Notes
1/I 1 v 'l'
! i�° �� 7'°� ] C,.
Total
Incorrectly
Unknown
Sump pumps
■
Foundation drains
Roof drains
41 oI Capri
Residential Sanitary Sewer Service
Compliance Inspection
Date. / 3 I / } --),' Time
Name / • - , f Disk #
PID Number
House Number
Alternative
r
4" to 6" Transition:
White Copy: Property Owner
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Ser vice Lateral Inspection Findings
Street Name
g am
pm
Address
0 nerl0ccupant Signature
Non - Compliance
Length of Service:
Yellow Copy: City of Eagan
Record Number 4
• ? O'
Time • /d pm
•
99 eC� '"
Phone F � I "�.�- _ �
Inspector Signature
For information calf 651.47 0.2788
Obstruction
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks Entered S L. at <=
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor. Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
Pink Copy: SEH