697 Oxford Rd - Inspection FormCompliance Inspection
Sanitary Sewer Service
Date 06P / 5l 0 5
Name f Pe 7 Are 44U DVD # 0 ( ""'E
House Number _A? S treet Name 3-1'4 ei,)
Alternative Mailing Address
Owner /Occupant Signature
Compliant
Non - Compliant
0 Incomplete Inspection
Service Lateral Inspection Findings
Poor Pipe
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Notes /Other . ` _c / /7.
4" to 6" Transition: Ad / A
/
Sump Pumps and Foundation Drains
( Sump Pumps Foundation Drains
Number: i Number:
Number Discharged: Number Discharged:
XCorrectly Correctly
Incorrectly _ Incorrectly
Unknown Unknown
Further Investigation
O No one home — left notice on door
O Access to Service Lateral needed
C) Cover replaced Time
C) Obstruction
C) Review Video
Time 7 c3 ani
- - Opm
Inspection Number
IS El
For Appointments call
612.219.4231
Number of stacks Entered S L.. at 7c J f7 C7
.• • V
Length of Service: !I ` e. S ,
Notes
White Copy: Property Owner Yellow Copy: City of Eagan
NMI
Inspector Signature
o �` -1 d }_ fob
Tirne 0, :20 am
O pm
Phone le rri k 0 V 7P7a2 S
Final Cleanout: 1/4/ /c 4,o c�..
Pink Copy: SEH