4778 London Lane - Inspection FormDate ) ) )(,
4" to 6" Transition:
411111 •
City of Capp
Residential Sanitary Sewer Service
Compliance inspection
Name 7 )1 Disk #
PID Number
House Number
Alternative Mailing Address
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
White Copy: Property Owner
Time
• cb am
• cf p
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
Length of Service:
Yellow Copy: City of Eagan
Record Number ,.. —
Time
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
am
•
• 0 pm
t
"....,2 i
Street Name • (3 /(.,?, () 1) ..,,,.--, J .
Phone (
.14edr)
For information calf 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
/ I
i
")
i ..-7 i: ..... ..
‘::-.,....
le ,
Number
D
Correctly
Incorrectly
Unknown
Sump pumps
/ '(4_...-k
- :::.5 I f % 4".
, /
Foundation drains
Roof drains
• I
\../
Date ) ) )(,
4" to 6" Transition:
411111 •
City of Capp
Residential Sanitary Sewer Service
Compliance inspection
Name 7 )1 Disk #
PID Number
House Number
Alternative Mailing Address
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
White Copy: Property Owner
Time
• cb am
• cf p
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
Length of Service:
Yellow Copy: City of Eagan
Record Number ,.. —
Time
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
am
•
• 0 pm
t
"....,2 i
Street Name • (3 /(.,?, () 1) ..,,,.--, J .
Phone (
.14edr)
For information calf 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH