2050 Marble Lane - Inspection FormSump pumps
' '
Foundation drains
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Roof drains
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City of Capo
Residential Sanitary Sewer Service
Compliance Inspection
Date / / f i. O' lime
CT) l ,/
Name Cl fir'' Disk#
PID Number j E
, 4. . Street Name _ ��- <C��
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance t
C7 No foundation drain connection
') J 11 \'
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
OwnerlOccupant Signature
White Copy: Pr operty Owner
„- ?,
am
i , pm
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 of stacks
Length of Service: i ▪ - ' 1 -
Number Discharged
Total Correctly Incorrectly Unknown
[1
Record Number
Entered 5 L at
Time i •
Phone
Obstruction
Linable to push past
feet
Notes
Inspector Signature
Final Cleanout:
am
Pm
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
Yellow Copy: City of Eagan Pink Copy: SEH