2075 Opal Dr - Inspection FormCity of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date / 1 71 V ,
Name � ? i✓° Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
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 1nsapection Findings
Roots ...
Poor Pipe joints
Mineral Deposits_
`'SaglPipe Deflection 2
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner
Total
f
L.�
1t 0 .0'0 0 am
Time P • X pm
Street Name
Correctly
I
Owterld"cciipant Signature;"
Damaged Pipe
Transition - ? f 7
Incorrectly
1
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 Discharged
Unknown
Record Number
Time
Phone ) ' 7
For ,iinformation call 651 2788
Obstruction
Unable to push past
feet
Number of stacks - Entered S. at
f!
inspector Signature
Length of Service: e-}j 4 - -__ Final Cleanout:
Notes
O am
Pm
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
f ! r �
1 1 J 1
7_
Yellow Copy: City of Eagan Pink Copy: SEH