4845 Sheffield Cir - Inspection FormCity or hpii
Residential Sanitary Sewer Service
Compliance Inspection
Date )C-1 1
Name
PID Number
House Number
4" to 6" Transition:
�! j
'
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
I; sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral inspection Findings Number of stacks
White Copy: Property Owner
Time
Disk #
c Street Name
Owner /Occupant Signature
am
�o pm
Length of Ser vice:
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
Time
Alternative ("failing Address Phone
in • Signature
Obstruction
Unable to push past
feet
Entered S.L.. at
Notes
Final Cleanout:
O am
•
• O pm
—
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection_
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH
f
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
, ,
mg
Foundation drains
Roof drains
,• - -.
� `
City or hpii
Residential Sanitary Sewer Service
Compliance Inspection
Date )C-1 1
Name
PID Number
House Number
4" to 6" Transition:
�! j
'
Compliance
0 No foundation drain connection
No roof drain connection
Sump pit not connected to
I; sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral inspection Findings Number of stacks
White Copy: Property Owner
Time
Disk #
c Street Name
Owner /Occupant Signature
am
�o pm
Length of Ser vice:
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
Time
Alternative ("failing Address Phone
in • Signature
Obstruction
Unable to push past
feet
Entered S.L.. at
Notes
Final Cleanout:
O am
•
• O pm
—
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection_
Damaged Pipe
Transition
Yellow Copy: City of Eagan Pink Copy: SEH
f