4680 Ridge Cliffe Dr - Inspection Forms4 11 ! 1111 ' City of Capan
Residential Sanitary Sewer Service
Compliance Inspection
-
Date. 1 } / 1 )(9
Name ,
PID Number
House Number.
Alternative Mailing Address
1 "
/ Street Name
Time
J
OwnerlOccuartt Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
• ( pm
Disk #
Non
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Record Number
For information call 651.470.2788
Roots / , -) v
d_: air l .2 '..¢- j 1 ✓—� V a
Minerd eposits --'/...4-%. "�' -;--' %° -?-!� , •7 i ;�t° '.f.:lt — e
✓rY fl
Damaged Pipe
Transition -4.„1
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
)t ime • tkpm
r �
1
Phone l P . � '' r - / ( ' f , . 7
; j
Inspector Signature
Obstruction
Unable to push past
feet
Entered S.L,at -'r
Final Cleano,r t:
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
•
CA' rI) ti ,'
Pink Copy: SEH
Number Discharged
N otgs
r, (,)
l 1 / , )( 1 ) G -/ - - ` l "
�= ?
`'i; /7) / - :,..1 ( .4: - _, - )..../.1—
Total
Correctly
Incorrectly Unknown
Sump pumps
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/ /
,: , �
r te -
Foundation drains
\
Roof drains
4 11 ! 1111 ' City of Capan
Residential Sanitary Sewer Service
Compliance Inspection
-
Date. 1 } / 1 )(9
Name ,
PID Number
House Number.
Alternative Mailing Address
1 "
/ Street Name
Time
J
OwnerlOccuartt Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
• ( pm
Disk #
Non
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks
Record Number
For information call 651.470.2788
Roots / , -) v
d_: air l .2 '..¢- j 1 ✓—� V a
Minerd eposits --'/...4-%. "�' -;--' %° -?-!� , •7 i ;�t° '.f.:lt — e
✓rY fl
Damaged Pipe
Transition -4.„1
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
)t ime • tkpm
r �
1
Phone l P . � '' r - / ( ' f , . 7
; j
Inspector Signature
Obstruction
Unable to push past
feet
Entered S.L,at -'r
Final Cleano,r t:
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
•
CA' rI) ti ,'
Pink Copy: SEH
1.,.. / "c. • ‘ r E , , w - , _ • ..-+_ . . e
"
Number Discharged
Unknown
Notes
._ .-
Total
Correctly
Incorrectly
Sump pumps
Foundation drains
Roof drains
Date 1
tItty al tap]
Residential Sanitary Sewer Service
Compliance inspection
Name Disk #
1-louse Number
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Npe Dints - 7'77?
MineraWeposits -'
Sag /Pi,p ,Deflection
Dama Pipe 1"
�
Transition
4" to 6" Transitionvi
White Copy: Property Owner
• o am
Time • o pm
PID Number
Street Name
Ownerl0ccupant Signature
For information calf 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewe r
O Flexible surnp pump piping
HT]
Number of stacks
lfT
1
Yellow Copy: City of Eagan
Record Number.
Time
Phone _
inspector Signature
Obstruction
Unable to push past
feet.
Entered S.L. at
3
o am
•
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
_] '
r
r r
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance inspection
my Eaaaii
Date 1: I'
Name
PID Number
House Number
Alternate Mailing Address /
fr., / . 7 '/`'
Compliance
a No foundation drain connection
0
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Owner /Occupant Sigr(tureN ,
Disk #
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
o Defective manholes
O Sump pump connected to
sanitary sewer
o Flexible sump pump piping
o am
O pm
Street Name
s Length of Service:
Yellow Copy: City of Eagan
Record Number , 4 i/ {C
For Information call 651.470.2788
Obstruction
1 j%te_
Phone
Unable to push past
I J ! feet.
Time
Inspector Signature
Number of stacks [ Entered S. L at S
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
. C !
t�f
Final Cleanout: 3
o am
o pm
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551
Total
Notes
Cc , . ].
�. , i;:. -
`•_'
c
; `5 I
. 4 - c_
..
)Ill c ..
?G
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
/X..
111111111
-
Foundation Brains
-� .
Roof Drains
i
Residential Sanitary Sewer Service
Compliance inspection
my Eaaaii
Date 1: I'
Name
PID Number
House Number
Alternate Mailing Address /
fr., / . 7 '/`'
Compliance
a No foundation drain connection
0
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
Owner /Occupant Sigr(tureN ,
Disk #
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
o Defective manholes
O Sump pump connected to
sanitary sewer
o Flexible sump pump piping
o am
O pm
Street Name
s Length of Service:
Yellow Copy: City of Eagan
Record Number , 4 i/ {C
For Information call 651.470.2788
Obstruction
1 j%te_
Phone
Unable to push past
I J ! feet.
Time
Inspector Signature
Number of stacks [ Entered S. L at S
No Access
O No one in
O Access to service lateral
needed
O Inspection refused
. C !
t�f
Final Cleanout: 3
o am
o pm
Pink Copy: Benjamin Franklin Plumbing
651 - 222 -1551