3636 Windtree Dr - Inspection FormCa of Capp
y �
Residential Sanitary Sewer Service
Compliance Inspection
Alternative MailingAddress .. .Phone
For information call 651.470.2788
Compliance
Q No foundation drain connection
No roof drain connection
Sump pit not connected tQ
sanitary sewer
Dated / l )� i
Name r # ;
PID Number
7 77
House Number Street Name
f\)'
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings Number of stacks 1
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition • r— r_ r
4" to 6 "Transition:
Owner /Occupant . Signature
White Copy: Property Owner
•J p am
Time • �pm
f
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:
l
Yellow Copy: City of Eagan
Record Number
. • C._i p,am
Time / • pm
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at 5 * s .
FYY
J� a
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
/
Foundation drains
� / •
,
Roof drains
Ca of Capp
y �
Residential Sanitary Sewer Service
Compliance Inspection
Alternative MailingAddress .. .Phone
For information call 651.470.2788
Compliance
Q No foundation drain connection
No roof drain connection
Sump pit not connected tQ
sanitary sewer
Dated / l )� i
Name r # ;
PID Number
7 77
House Number Street Name
f\)'
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings Number of stacks 1
Roots
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition • r— r_ r
4" to 6 "Transition:
Owner /Occupant . Signature
White Copy: Property Owner
•J p am
Time • �pm
f
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:
l
Yellow Copy: City of Eagan
Record Number
. • C._i p,am
Time / • pm
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at 5 * s .
FYY
J� a
Final Cleanout:
Pink Copy: SEH