4184 Diamond Dr - Inspection FormsCity o1 Ca ii
Residential Sanitary Sewer Service
Compliance Inspection
{
}
Date 1 ! 1
Name j ! /fj
PID Number
House Number
Alternative Mailing Address
Ownerl&c upant Signature
Compliance
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 Finding's Number of stacks
Roots , .
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
.7• ` oam
Time. __ •_
yi - Disk
' i
4_ Street Name
�.1 J
Pm
■■••
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
Yellow Copy: City of Fagan
Record Number.
�E7
Phone I ( 74
For information calf 651.470.2788
Obstruction No Access
Unable 4o push past 0 No one in
j 1 °feet
Entered St at
`.6C "P /416
j
Length of Service: /4 j j
Notes
•
Time •
tspector Signature
Pdyg
Dam
pm
Ater
O Access to service
lateral needed
O Inspection
refused
▪ Final Cleanout: Y f' .
,r L�
5.E a9
Pink Copy: SEH
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
fl...--
,
Roof drains
City o1 Ca ii
Residential Sanitary Sewer Service
Compliance Inspection
{
}
Date 1 ! 1
Name j ! /fj
PID Number
House Number
Alternative Mailing Address
Ownerl&c upant Signature
Compliance
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 Finding's Number of stacks
Roots , .
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
.7• ` oam
Time. __ •_
yi - Disk
' i
4_ Street Name
�.1 J
Pm
■■••
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
Yellow Copy: City of Fagan
Record Number.
�E7
Phone I ( 74
For information calf 651.470.2788
Obstruction No Access
Unable 4o push past 0 No one in
j 1 °feet
Entered St at
`.6C "P /416
j
Length of Service: /4 j j
Notes
•
Time •
tspector Signature
Pdyg
Dam
pm
Ater
O Access to service
lateral needed
O Inspection
refused
▪ Final Cleanout: Y f' .
,r L�
5.E a9
Pink Copy: SEH
411110. City a('agp
Residential Sanitary Sewer Service
Compliance Inspection
e'?
Date ! j` . / 1(
Name
P1D Number
House Number
Alternative Mailing Address
4
0 ner'i&c6ipant Signature
Compliance
No foundation drain connection
A C No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
"1 11 fs j/ - Disk #
Service Lateral Inspection Findings
J ✓ r f )
Roots
White Copy: Pr operty Owner
1 1 - Street Name
1)
oam
Time • W pm
9
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
Length of Service: ;
Yellow Copy: City of Eagan
Record Number
• , 41_'" oam
Time • A pm
Phone a -; ,
Obstruction
Unable /o push past
( %) "'1° - feet
- inspector Signature
Number of stacks _ 1 Entered S L. at
No Access
O No one in
Final Cleanout: r ?
O Access to service
lateral needed
O Inspection
refused
J?
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
5E H &off / <bQ aG
Pink Copy: SEH
Number
Discharged
Total
Correctly
--
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
(
411110. City a('agp
Residential Sanitary Sewer Service
Compliance Inspection
e'?
Date ! j` . / 1(
Name
P1D Number
House Number
Alternative Mailing Address
4
0 ner'i&c6ipant Signature
Compliance
No foundation drain connection
A C No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
"1 11 fs j/ - Disk #
Service Lateral Inspection Findings
J ✓ r f )
Roots
White Copy: Pr operty Owner
1 1 - Street Name
1)
oam
Time • W pm
9
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
Length of Service: ;
Yellow Copy: City of Eagan
Record Number
• , 41_'" oam
Time • A pm
Phone a -; ,
Obstruction
Unable /o push past
( %) "'1° - feet
- inspector Signature
Number of stacks _ 1 Entered S L. at
No Access
O No one in
Final Cleanout: r ?
O Access to service
lateral needed
O Inspection
refused
J?
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
5E H &off / <bQ aG
Pink Copy: SEH