853 Wescott Square - Inspection Form4 011. . City of Cap
Residential Sanitary Sewer Service
Compliance Inspection
/
Name,"- 2
Alternative Mailing Address
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Eloper ty Owner
o phance
No foundation drain connection
tj
No roof drain connection
y Sump pit not connected to
1
Transition
I ..."9.C.X,--. am
A
Time ,2
. � pm
PID Number
Owner/Occupant Signature
1 Disk # 72
) '7)
) ik
House Number Street Name
Phone />m
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks 1 Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
) , 1
•
Length of Service: 4 (e
Yellow Copy: City of Eagan
Record Number
Time t
l
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
1
a
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
, r
ti. ':) eT../y7/72
, --
Foundation drains
/
Roof drains
4 011. . City of Cap
Residential Sanitary Sewer Service
Compliance Inspection
/
Name,"- 2
Alternative Mailing Address
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Eloper ty Owner
o phance
No foundation drain connection
tj
No roof drain connection
y Sump pit not connected to
1
Transition
I ..."9.C.X,--. am
A
Time ,2
. � pm
PID Number
Owner/Occupant Signature
1 Disk # 72
) '7)
) ik
House Number Street Name
Phone />m
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks 1 Entered S.L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
) , 1
•
Length of Service: 4 (e
Yellow Copy: City of Eagan
Record Number
Time t
l
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
1
a
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH