1637 Covington Lane - Inspection Formr
Number
Correctly
Discharged
Incorrectly Unknown
Notes
'1
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Total
Sump pumps
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t 1,�c.�Y�
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Foundation drains
Roof drains
®N -
4 City of Capri
Y
Residential Sanitary Sewer Service
Compliance Inspection
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Time • tpm
7 f
Date 1 . ... ;1
Name P` f ' a c°- r '.ri '' Disk # L
PID Number
House Number L.'') _ Street Name
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4" to 6" Transition:
White Copy: Property Owner
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�'x'• { x 1. � ✓��� -'"'° ,e..�•
Ownef tcupar Signature
Compliance
O No foundation drain connection
v
• No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
WPM
Non - Compliance
O Clear• water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
W. Flexible sump pump piping
F.
Transition
Yellow Copy: City of Eagan
Record Number
Time
1 . ` 1 ( ° ' . � —; :.1- r / te r
«. , w?
Alternative Mailing Address Phone (: J) A- ..) 1 '-
1. .
• p am
• O Pm
I
Obstruction
Unable to push past
feet
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered 5 L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ter rr 11
Length of Service: %` "'�'Fnal Cfeanout: < ' `
Pink Copy: SEH
For information call 651.470.2788