4715 Walden Dr - Inspection Form4 111. City of Cap
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date ._ / l / l
Name
House Number
PID Number
1
J Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Owner
Time'
Disk #
am
pm
Number of stacks
Length of Service:
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
Entered S L. at
Alternative Mailing Address ) Phone / -
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• ej
inspector Signature )
J im C .1.4 Ind/ 1. �)
For information call 651.470.2788
No Access
O No one in
7;
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
� � ,3 e. `,% 1 .
i °
f c �7
Total
Sump pumps
1
'� p t�
t.-..y
i �
Foundation drains
Roof drains
-'i
4 111. City of Cap
Y
Residential Sanitary Sewer Service
Compliance Inspection
Date ._ / l / l
Name
House Number
PID Number
1
J Street Name
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy: Property Owner
Time'
Disk #
am
pm
Number of stacks
Length of Service:
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
Entered S L. at
Alternative Mailing Address ) Phone / -
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• ej
inspector Signature )
J im C .1.4 Ind/ 1. �)
For information call 651.470.2788
No Access
O No one in
7;
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH