4854 Richard Lane - Inspection Form4114 City of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date i / lr
•
Name
i
Disk # �1
PID Number
A
Alternative Mailing Address Phone r ""
i
House Number tai ' •Street Name
'/ ) {
?Si
For information call 651.470.2788
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
4" to 6" Transition:
White Copy: Propel ty Owner
•C.r : em
Time • 8 pm
OwnerlOccupant Signature
L
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:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
O am
•
• O pm
Final Cleanout:
•
Inspector Signature ±, l ) r i r� f / ir �¢�✓
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
" �
Total
- _ " =-- :''' _
-. ,, a ..
' Pr' M. r
CA f >ft ::
Sump pumps
Foundation drains
Mill
' ° d
)
( I152 ' I
Roof drains
4114 City of Capp
Residential Sanitary Sewer Service
Compliance Inspection
Date i / lr
•
Name
i
Disk # �1
PID Number
A
Alternative Mailing Address Phone r ""
i
House Number tai ' •Street Name
'/ ) {
?Si
For information call 651.470.2788
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
4" to 6" Transition:
White Copy: Propel ty Owner
•C.r : em
Time • 8 pm
OwnerlOccupant Signature
L
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:
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
O am
•
• O pm
Final Cleanout:
•
Inspector Signature ±, l ) r i r� f / ir �¢�✓
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered St at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH