4838 Sheffield Lane - Inspection FormCity of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name _/ _
PID Number
House Number
4" to 6" Transition:
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
Sump pit not connected to
/ sanitary sewer
Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings Number of stacks
Sump pumps
Foundation drains
Roof drains
Total
li
Correctly Incorrectly Unknown
White Copy: Property Owner
°y :' q a m
Time,? • .. o prn
•'7
Street Name
Owner /Occupant Signature
1 Disk # -
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:
Number Discharged
Record Number
•
;) r
Phone
Time
Obstruction
Unable to push past
feet.
Entered S L. at
Notes
inspector Signature • r .w
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
•
• O am
• :o prn
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH