1331 St Andrew Blvd - Inspection Form1
1
411 City of Eagan
Compliance Inspection
Sanitary Sewer Service
Date (1 I (X Time OF: an'
m
Name 6 M11/ ; 6`' DVD
House Number ___ /-rf f Street Name tf ' ( rf
Alternative Mailing Address
Ownej Occupant Signature
Compliant
• Non - Compliant
O Incomplete Inspection
4" to 6" Transition: f
Further Investigation
Sump Pumps and Foundation Drains
[) No one home — left notice on door
U Access to Service Lateral needed
O Cover replaced Time
(0 Obstruction
(0 ReviewVideo
m p Pum Foundation Drains
Number: Number:
Number Discharged: Number Discharged:
,___ Correctly __ Correctly
Incorrectly _- Incorrectly
Unknown ,_,._ Unknown
Inspection Number „� -- t r
i
,.w.y.. i :.4,_____
Ar
r ./ nSectar Signature
For Appointments call
612.219.4231
Service Lateral Inspection Findings Number of stacks 2 . Entered S.E.. at -CLL. 3fAi: (' '
A
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Notes /Other
Length of Service: i
r
Notes
fr ' %' r .
3
White Copy: Property Owner Yellow Copy: City of Eagan
t
Time C lam
O pro
Phonel trd/ 7 w '
Final Cleanout:`i. �.
Pink Copy: SEH