4860 Sheffield Lane - Inspection Form411 City of Ca as
Residential Sanitary Sewer Service
Compliance Inspection
Date ii 1/ r
� 1 J) V 1 _
Name d/
PID Number
House Number 5 2 Street Name
Alternative Mailing Address
For information call 651 .470.2788
Compliance
O No foundation drain connection
6j No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
j
31.3 Disk##
am
Time • V. pm
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Transition
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
Number of stacks
Damaged Pipe. _
Length of Service:
Yellow Copy: City of Eagan
/1
f
Notes
)
Obstruction
Unable to push past
feet
Record Number '
p am
•
Time • _ -:«C- pm
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S . at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Pink Copy: SEH
Total
Number
Discharged
Correctly
Inco
Unknow n
Sump pumps
- ...#
MEI
r
r
Foundation drains
Roof drains
..
�ef
FM
411 City of Ca as
Residential Sanitary Sewer Service
Compliance Inspection
Date ii 1/ r
� 1 J) V 1 _
Name d/
PID Number
House Number 5 2 Street Name
Alternative Mailing Address
For information call 651 .470.2788
Compliance
O No foundation drain connection
6j No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
j
31.3 Disk##
am
Time • V. pm
Owner /Occupant Signature
Service Lateral Inspection Findings
Roots
Transition
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
Number of stacks
Damaged Pipe. _
Length of Service:
Yellow Copy: City of Eagan
/1
f
Notes
)
Obstruction
Unable to push past
feet
Record Number '
p am
•
Time • _ -:«C- pm
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S . at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Pink Copy: SEH