4785 London Lane - Inspection FormCity of Caian
Residential Sanitary Sewer Service
Compliance Inspection
yy LL
Date 1 4 — i !�J 1: Time • . 9
Name �� f( Disk #
PID Number
g3 Street Name
House Number
/ r
r �4
OwrrerfCrccorpant Signature
Compliance
O No foundation drain connection
. No roof drain connection
/ Q Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
c
am
pm
Non - Compliance
Length of Service:
Recordinber
-7 .
Time •
Alternative Mailing Address Phone
For information call 65 1.470.2788
Yellow Copy: City of Eagan
Obstruction
Inspector Signature
pm
No Access
O Clear water connections to Unable to push past 0 No one in
sanitary sewer feet.
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral t spection Findings Number of stacks 1 Entered S,L.at - °=') e .= ";; j j ,•�'
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
r
O Access to service
lateral needed
O Inspection
refused
?Final Cleanout J`
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
N / } ) i ; / , uf 2
�" ! ,
J �
ji
1 ` K._,/ i ii ! ° - '/ i - � � % '
f �_-
}
Total
Sump pumps
Foundation drains
Roof drains
City of Caian
Residential Sanitary Sewer Service
Compliance Inspection
yy LL
Date 1 4 — i !�J 1: Time • . 9
Name �� f( Disk #
PID Number
g3 Street Name
House Number
/ r
r �4
OwrrerfCrccorpant Signature
Compliance
O No foundation drain connection
. No roof drain connection
/ Q Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
c
am
pm
Non - Compliance
Length of Service:
Recordinber
-7 .
Time •
Alternative Mailing Address Phone
For information call 65 1.470.2788
Yellow Copy: City of Eagan
Obstruction
Inspector Signature
pm
No Access
O Clear water connections to Unable to push past 0 No one in
sanitary sewer feet.
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral t spection Findings Number of stacks 1 Entered S,L.at - °=') e .= ";; j j ,•�'
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
r
O Access to service
lateral needed
O Inspection
refused
?Final Cleanout J`
Pink Copy: SEH