4253 Amber Dr - Inspection Formr City of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
1
Transition
4" to 6" Transition:
•(��� am
)� Time pm
Tr: rZ �, 7
#11 P4Disk #
PlD Number
House Number 7Street Name
Alternative Mailing Address
For information call 651.470.2788
pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral 1?spe, ion Findings
Roots +
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
White Copy: Property Owner
OwnerlOccupant Signature
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
Number of stacks l
7
Length of Service:
Yellow Copy: City of Eagan
Record Number
Notes
Time
,--
Phone
Entered S L. at
lns6ctor Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
�°� ✓= )■111
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH
Number.
Correctly
Discharged
Incorrectly
Unknown
Total
71
J
Sump pumps
Foundation drains
(9
Roof drains
✓�
r City of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
1
Transition
4" to 6" Transition:
•(��� am
)� Time pm
Tr: rZ �, 7
#11 P4Disk #
PlD Number
House Number 7Street Name
Alternative Mailing Address
For information call 651.470.2788
pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral 1?spe, ion Findings
Roots +
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
White Copy: Property Owner
OwnerlOccupant Signature
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
Number of stacks l
7
Length of Service:
Yellow Copy: City of Eagan
Record Number
Notes
Time
,--
Phone
Entered S L. at
lns6ctor Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
�°� ✓= )■111
O Access to service
lateral needed
O inspection
refused
Pink Copy: SEH