4655 Pinetree Curve - Inspection FormResidential Sanitary Sewer. Service
Compliance Inspection
J i
Date 2 / f , %. /
Name ? l� / f,
PID Number
House Number
Alternative Mailing Address
L
!7 •::'0 o am
Time m. • pm
Disk #
�._ Street Name
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
.'NO roof drain connection
Sump pit not connected to
sanitary sewer
,61 Sump pump properly piped
0 No sump pump
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
S s
ate• Time pm
r ' r
Phone _ -
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks .. Entered S,L,at ?, '1° ° :» ;
Roots
Poor Pi pe Joints
Mineral Deposits_ -
SaglPipe Deflection
Damaged Pipe - - -
Transition
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
L.
Final Cleanout•
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Notes
Total
Sump pumps
j
Foundation drains
I
Roof drains
Residential Sanitary Sewer. Service
Compliance Inspection
J i
Date 2 / f , %. /
Name ? l� / f,
PID Number
House Number
Alternative Mailing Address
L
!7 •::'0 o am
Time m. • pm
Disk #
�._ Street Name
Owner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
.'NO roof drain connection
Sump pit not connected to
sanitary sewer
,61 Sump pump properly piped
0 No sump pump
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
S s
ate• Time pm
r ' r
Phone _ -
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks .. Entered S,L,at ?, '1° ° :» ;
Roots
Poor Pi pe Joints
Mineral Deposits_ -
SaglPipe Deflection
Damaged Pipe - - -
Transition
4" to 6" Transition:
White Copy: Property Owner
Length of Service:
Yellow Copy: City of Eagan
L.
Final Cleanout•
Pink Copy: SEH