4846 Sheffield Lane - Inspection FormResidential Sanitary Sewer Service
41 City of Capri Compliance Inspection
Date :)/ '9. /1 .X.;
$
Name , Disk #
PID Number
Rouse Number d- i - e . 71 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
am
Time F ie '6 Pm
ri)
• - ' .
• OwnerlOccupant Signature
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
r1
Time •
• o am
o pm
?+"
Obstruction
Unable to push past
feet
Entered S L at
Final Cleanout:
No Access
O No one in
O Inspection
refused
• I X •7
inspector'Signuture „/
For information call 651.470.2788
O Access to service
lateral needed
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Notes
I
" ' - --1 -- - - s ,...----,---, 1
(:-."):-.: ',.
) --;:4- ......---- - (-).--)-
:_.-- 7/
Total
Incorrectly
Unknown
Sump pumps
I
/7
, ,..
- 4.- .--• ,,
747: i 7 i ,:,,
( P
-
/
','/Vr 4--
Foundation drains
Roof drains
(/
---/.
(.."
Residential Sanitary Sewer Service
41 City of Capri Compliance Inspection
Date :)/ '9. /1 .X.;
$
Name , Disk #
PID Number
Rouse Number d- i - e . 71 Street Name
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
am
Time F ie '6 Pm
ri)
• - ' .
• OwnerlOccupant Signature
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
r1
Time •
• o am
o pm
?+"
Obstruction
Unable to push past
feet
Entered S L at
Final Cleanout:
No Access
O No one in
O Inspection
refused
• I X •7
inspector'Signuture „/
For information call 651.470.2788
O Access to service
lateral needed
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH