4354 Jasper Dr - Inspection Form4 1111* City of two
Residential Sanitary Sewer Service
Compliance Inspection
i fs •fit
Date 1 1 f l Time 4 •
Name /a ) ()4.7
PHD Number
House Number � f Street Name
Alternative MailingAddress Phone (;71_ 1 "' i5 '' C 7 1
)
1
For information call 651.470.2788
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 F ndingt
Roots_ z 3 ? *
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
Disk #
am
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
Record Number
Obstruction
Unable to push past
feet
Number of stacks / Entered S.Lat
at
• oam
Time • 1 pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
�.i
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: / A Cjt
Pink Copy: SFH
Number Discharged
Notes
Total Correctly Incorrectly
Unknown
Sump pumps
®--
-' MEE
/
Foundation drains
Roof drains
4 1111* City of two
Residential Sanitary Sewer Service
Compliance Inspection
i fs •fit
Date 1 1 f l Time 4 •
Name /a ) ()4.7
PHD Number
House Number � f Street Name
Alternative MailingAddress Phone (;71_ 1 "' i5 '' C 7 1
)
1
For information call 651.470.2788
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 F ndingt
Roots_ z 3 ? *
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
Disk #
am
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
Record Number
Obstruction
Unable to push past
feet
Number of stacks / Entered S.Lat
at
• oam
Time • 1 pm
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
�.i
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: / A Cjt
Pink Copy: SFH