1590 Norwood Cir - Inspection FormsResidential Sanitary Sewer Servic
Compliance Inspection
Date 1 " /
Name
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Ownei
` _.% / 2( Disk #
1
I Street Name
Time •
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
/'O, am
.6? pm
For information call 651.470.2788
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
-m -L1J
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O Prr
•
Phone %
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
E=ntered S. L at
Pink Copy: SEH
Number Discharged
N otes 1---/ ---- __;, r-- �_. r
c - `.. - 1 --/'7 E
�. i '7°"" _ ` :. / y / ; ,.:_ - 1 • ; - , r :
` _ `a f
` ` .', -
-,
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Servic
Compliance Inspection
Date 1 " /
Name
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
White Copy: Property Ownei
` _.% / 2( Disk #
1
I Street Name
Time •
OwnerlOccupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
/'O, am
.6? pm
For information call 651.470.2788
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
-m -L1J
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
• O am
• O Prr
•
Phone %
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
E=ntered S. L at
Pink Copy: SEH
4 oft two
Residential Sanitary Sewer Service
Compliance Inspection
J l . /
Date's
Name r ). /-2/ - f
PID Number
i ce 7
House Number ! _ "� - %
Street Name 1 J
Alternative Mailing Address
1
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6” Transition:
White Copy: Proper ty Owner
_ •. ,) cram
Time '' • o pm
Disk #
rj
—
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
a
1 r .� �- f ,e�
Poor ipeJ9r <.=" f= -r s / , , ` , - , ;V7 : ` 7L. an4 ° ; ; r ✓J
1
Minera Deposits ?
F r^
Sag/Pipe Deflection V.,-1 . : =� _
Pine
T7�M�Damaged . '"% ^' r,_, -f y- v . _ ".`"' --7 �` ��."' ,.,,-
�` = / / r' ,�: ,r-''' - }ter'_
Transition
Phone = ��
Length of Service:
Yellow Copy: City of Eagan
Record Number. ._`r
Obstruction
Unable to push past
,ii
Ccc -E feca.0
y
d am •
Time • O pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
7 • Entered S.L,at
)1iC:`1 ; f,
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Noes - _
/ ; f r r 0 % ; ' , , „ %1::
- ;_
1
Total
Sump pumps
Foundation drains
Roof drains
4 oft two
Residential Sanitary Sewer Service
Compliance Inspection
J l . /
Date's
Name r ). /-2/ - f
PID Number
i ce 7
House Number ! _ "� - %
Street Name 1 J
Alternative Mailing Address
1
OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6” Transition:
White Copy: Proper ty Owner
_ •. ,) cram
Time '' • o pm
Disk #
rj
—
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
a
1 r .� �- f ,e�
Poor ipeJ9r <.=" f= -r s / , , ` , - , ;V7 : ` 7L. an4 ° ; ; r ✓J
1
Minera Deposits ?
F r^
Sag/Pipe Deflection V.,-1 . : =� _
Pine
T7�M�Damaged . '"% ^' r,_, -f y- v . _ ".`"' --7 �` ��."' ,.,,-
�` = / / r' ,�: ,r-''' - }ter'_
Transition
Phone = ��
Length of Service:
Yellow Copy: City of Eagan
Record Number. ._`r
Obstruction
Unable to push past
,ii
Ccc -E feca.0
y
d am •
Time • O pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
7 • Entered S.L,at
)1iC:`1 ; f,
Final Cleanout:
Pink Copy: SEH