4843 Sheffield Lane - Inspection FormSump pumps
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Foundation drains
Roof drains
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City of Cd r
Residential Sanitary Sewer Service
Compliance Inspection
Date )(4
Name te ' // it
PID Number
House Number
y3 �'
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
(Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
506 am
Time)_s / O pm
Disk #
- f `Street Name
Owner /Qccupont Signature
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
Number Discharged
Total Correctly
-LL�-
O Flexible sump pump piping
Number of stacks
Length of Service:
Notes
ncorrectly Unknown 4j,/
Yellow Copy: City of Fagan
Record Number )
Time
Alternative Mailing Address Phone !� ! M is")
`
-. 1 / f
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
0 am
• _ O pm
Inspector Signature I �rm , P }' Ptr
O Inspection
refused
Entered S..L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
7 r �,F ti
° f"1
:
;11
No Access
O No one in
O Access to service
lateral needed
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance Inspection
7') f (
Date 1/ / 11 1 Time •
4
Name Disk #
PD Number
House Number
Alternative Mailing Address
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
4" to 6"Transition:
White Copy: Property Owner
Street Name
OwnerlOccupant Signature
Findings
am
Pm
Mb.
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
Record Number
) //)
7 '.7
Phone
N ot es
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
• 0 am
• 0 pm
Inspector Signature
For information call 651.470.2788
No Access
No one
0 Access to service
lateral needed
0 Inspection
refused
Entered SL at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
IIII
IIII
Foundation drains
Roof drains
1111
Residential Sanitary Sewer Service
Compliance Inspection
7') f (
Date 1/ / 11 1 Time •
4
Name Disk #
PD Number
House Number
Alternative Mailing Address
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
4" to 6"Transition:
White Copy: Property Owner
Street Name
OwnerlOccupant Signature
Findings
am
Pm
Mb.
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
Record Number
) //)
7 '.7
Phone
N ot es
Time
Obstruction
Unable to push past
feet.
Final Cleanout:
• 0 am
• 0 pm
Inspector Signature
For information call 651.470.2788
No Access
No one
0 Access to service
lateral needed
0 Inspection
refused
Entered SL at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH