2112 Shale Lane - Inspection FormCompliance
,® No foundation drain connection
,el No roof drain connection
O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
N 7
CA No sump pump
For information call 651.470.2788
No Access
0 No one in
0 Access to service
lateral needed
0 Inspection
refused
Non - Compliance
0 Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
0 Flexible sump pump piping
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S. L. at f: -` 1.- ' ^
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
r
Transition 4 .--J , •?r . r -r- „r`,
4" to 6" Transition: Length of Service: ` c.` w ,, Final Cleanout: ! );F'. /2
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
-- r
' 1, '
(
Foundation drains
Roof drains
' ; '
Residential Sanitary Sewer Service
Inspection
� p p �� Com ection
D ) I r'
Name f
PID Number
House Number
Alternative Mailing Address
White Copy: Property Owner
} _ill,. 3 0 am
Time • Q pm
Street Name
OwnerlOccupant Signature
Yellow Copy: City of Eagan
Record Number
L Time
Phone
f._
inspector Signature
j 4 0 am
Pm
Pink Copy: SEH