1473 Thomas Lane - Inspection FormCity of Capp
Residential Sanitary Sewer Service
Compliance inspection
Date i? 7/ 2 7 1 / 2
Name / 67 ' 2,1 / �C �
PID Number
I -louse Number
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
•
�
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
• Time / /° pm
ak 1E—W —[1J
Street Name _ 77;1) 7/f L'L'
Non - Compliance
0
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Record Number
0 am
•
Time ® 0 pm
Phone '
/I "'
nspector Signature
s�
For information call 651:470.2788
Obstruction
Unable to push past.
feet
Entered 5 L at
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
i
Co
r
ff /� r � 31'
1 , /-
/ _ --7- d
Notes
•
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pump
(
AM )
Foundation drains
i
Roof drains
City of Capp
Residential Sanitary Sewer Service
Compliance inspection
Date i? 7/ 2 7 1 / 2
Name / 67 ' 2,1 / �C �
PID Number
I -louse Number
Alternative Mailing Address
Owner /Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
•
�
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
• Time / /° pm
ak 1E—W —[1J
Street Name _ 77;1) 7/f L'L'
Non - Compliance
0
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
Record Number
0 am
•
Time ® 0 pm
Phone '
/I "'
nspector Signature
s�
For information call 651:470.2788
Obstruction
Unable to push past.
feet
Entered 5 L at
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
i
Co
r
ff /� r � 31'
1 , /-
/ _ --7- d
Notes
•
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance inspection
or Eapa
Date 7 Pc
PID Number
Name
House Number
Damaged Pipe
Transition
/
Time
Disk #
Owner /Occupant Signature
Compliance
D: No foundation drain connection
Sump pit not connected to
sanitary sewer
O Sump Pump properly piped
o No sump pump
No roof drain connection
Service Lateral Inspection Findings
;, ? S
4" to 6" Transition:
White Copy: Property Owner
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
Roots
Poor Pipe Joints /)� jeD } ` 3 ! 4/{')
Mineral Deposits
Sag /Pipe Deflection
C .
o am
o pm
Street Name
Yellow Copy: City of Eagan
Record Number J /if /9-7
m
Time
Alternate Mailing Address Phone
. =-c
For Information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks Entered S L at " 5
Length of Service: / ! I
Inspector Signature
O am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
C 3 , LC 1 L Gi
Final Cleanout:.
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Number
Total Correctly
Discharged
Incorrectly
.
Unknown
MI
III
Notes
- 4 - dc.-- -. .. c , .L
: S I, . • ..7,.. ..- . .
I=/�. r R. - L
6 \ J So T� C. ,..,,, r-.
i. , -,, '� P: A '
(f4 c ' ✓ c ,...) GCr 1 ( g
Sump Pumps ®-®-
Foundation Drains
`'
Roof Drains
--
Residential Sanitary Sewer Service
Compliance inspection
or Eapa
Date 7 Pc
PID Number
Name
House Number
Damaged Pipe
Transition
/
Time
Disk #
Owner /Occupant Signature
Compliance
D: No foundation drain connection
Sump pit not connected to
sanitary sewer
O Sump Pump properly piped
o No sump pump
No roof drain connection
Service Lateral Inspection Findings
;, ? S
4" to 6" Transition:
White Copy: Property Owner
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
Roots
Poor Pipe Joints /)� jeD } ` 3 ! 4/{')
Mineral Deposits
Sag /Pipe Deflection
C .
o am
o pm
Street Name
Yellow Copy: City of Eagan
Record Number J /if /9-7
m
Time
Alternate Mailing Address Phone
. =-c
For Information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks Entered S L at " 5
Length of Service: / ! I
Inspector Signature
O am
o pm
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
C 3 , LC 1 L Gi
Final Cleanout:.
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551