4853 Sheffield Cir - Inspection FormCity of 1a ,au
Residential Sanitary Sewer Service
Compliance Inspection
Date II !' Time
) /
Name*, ) / f ( Disk #
PID Number
House Number �`� Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
d Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings Number of stacks
4" to 6 "Transition:
White Copy: Property Owner
OwnerlOccupant Signature
/)
am
pm
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
Yellow Copy: City of Eagan
Record Number
Time
Phone /.; L ) 6 ) ) L 7,
Insctor Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L at
lam
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
rig /Pipe Deflection .
Damaged Pipe
Transition
Length of Service: I r
Final Cleanout: " _
Pink Copy: SEH
Total
Notes
�` i
' , _—
} , ,--1`
—
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=. ( /if')
(
, i
1 i
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
f
P , . i
j) e I ,
0 C'}
V J' '4,.."
Foundation drains
Roof drains
City of 1a ,au
Residential Sanitary Sewer Service
Compliance Inspection
Date II !' Time
) /
Name*, ) / f ( Disk #
PID Number
House Number �`� Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
No roof drain connection
d Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings Number of stacks
4" to 6 "Transition:
White Copy: Property Owner
OwnerlOccupant Signature
/)
am
pm
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
Yellow Copy: City of Eagan
Record Number
Time
Phone /.; L ) 6 ) ) L 7,
Insctor Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L at
lam
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
rig /Pipe Deflection .
Damaged Pipe
Transition
Length of Service: I r
Final Cleanout: " _
Pink Copy: SEH