1489 Pinetree Pass - Inspection FormCity of Caen
Residential Sanitary Sewer Service
Compliance Inspection
Date : � ' ;L }
Name ._ A, =, , =', .' (, y D
PID Number
House Number
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
4" to 6" Transition:
White Copy: Property Owner
J � Nsi'
0- e O am
Time • o pm
Street Name
Alternative Mailing Add ss
.. Owner /Occupant Signature
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
-m -m
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone
Obstruction
Unable to push past
feet
Final Cleanout:
a
O am
•
® O pm
No Access
O No one in
Inspector Signature .A)
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
3"" � )
1 ° � �,!" 3r I Y t e1 ' ..
-
Total
Sump pumps
9
K .A
..1
--
Foundation drains
Roof drains
�
I
City of Caen
Residential Sanitary Sewer Service
Compliance Inspection
Date : � ' ;L }
Name ._ A, =, , =', .' (, y D
PID Number
House Number
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
4" to 6" Transition:
White Copy: Property Owner
J � Nsi'
0- e O am
Time • o pm
Street Name
Alternative Mailing Add ss
.. Owner /Occupant Signature
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
-m -m
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone
Obstruction
Unable to push past
feet
Final Cleanout:
a
O am
•
® O pm
No Access
O No one in
Inspector Signature .A)
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Pink Copy: SEH