2061 Copper Lane - Inspection FormCity of tarp
Residential Sanitary Sewer Service
Compliance Inspection
33
Date / }_ I J I�
Name
PID Number
House Number _ ; n Street Name
/ / ..
f, Ov ner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
")---
Roots i
Poor Pipe joints
Mineral Deposits_
4" to 6 "Transition:
White Copy: Property Owner
/ • am
Time C • pm
Disk
•
Alternative Mailing Address Phone
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
- �
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
,
Record Number
Notes
f
• am . / (. :
Time • 0 pm
Obstruction
Unable to push past
feet
inspector Signature
For information call 651.470.2788
No Access
O No one in
Entered S.L.at
•
O Access to service
lateral needed
O inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
_
Foundation drains
L ,- " ,' )'
'
i ✓:
11 ' . / .. . ..
/ ° � ,_. .-
' ' 4 . "' - " - -2 ' - 9 ,`
0111.1111
'
Roof drains
/1
City of tarp
Residential Sanitary Sewer Service
Compliance Inspection
33
Date / }_ I J I�
Name
PID Number
House Number _ ; n Street Name
/ / ..
f, Ov ner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
")---
Roots i
Poor Pipe joints
Mineral Deposits_
4" to 6 "Transition:
White Copy: Property Owner
/ • am
Time C • pm
Disk
•
Alternative Mailing Address Phone
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
- �
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
,
Record Number
Notes
f
• am . / (. :
Time • 0 pm
Obstruction
Unable to push past
feet
inspector Signature
For information call 651.470.2788
No Access
O No one in
Entered S.L.at
•
O Access to service
lateral needed
O inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH