4840 Steeplechase Cir - Inspection Forms
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Compliance Inspection
DateQ 1'}5I Di Time/ 7:30 02- Inspection Number -S T
PM
Name DVD Time o PM
_ m
House Number J Street Name c4 f~C L P
Alternative Mailing Address Phone r,67411tfs."
OwnerlOccupant Signature Inspector Signature
0 Compliant
0 Non-Compliant ForAppointments call
Incomplete Inspection f_ /t,~.,;ZS 612-219.4231
Service Lateral Inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Notes/Other
4" to 6" Transition: Length of Service Final Cleanout:
Sump Pumps and Foundation Drains Notes
Sump Pumrs Foundation Drains
Number: Number: /7,.5
[,umber Discharged: Number Discharged:
''I~
; P Foe
Correctly Correctly
Incorrectly _ Incorrectly fN_ Y
Unknown Unknown
,Further Investigation Z~/7 -21~
p No one home left notice on door
0 Access to Service Lateral needed 7~`~ _77
0 Cover replaced 'rime 7
Q Obstruction
0 Review Video
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White Conv_ PrnnPrrv nwnar YPlln... r'nn~.•,t^[r: T 'sue' - a:.~. rcu
V. r--- -
Compliance Inspection
SI I - _
„ 'Time O am Inspection. Number 1 I-—
PM
am
DVD ® Time C G
umber _ ~'fv T Street Name Jib, C"rr'f11 tPc C. - -
dive Mailing Address Phone f
0 erlQcc pant !gnat ure Inspector Signature
0 Compliant ForAppointments call
0 Non.-Compliant
612.219.4231
Incomplete Inspection -W.AC(,e` 7t.
Service Lateral Inspection Findings Number of stacks Entered S.L. at _WS -
F
Roots
Poor Pipe joints _
Mineral Deposits
SaglPipe Deflection
Damaged Pipe - _ - _T--~~_
7 r, ._Z r :_f y
Notes/Other' < (1. 12 L-)4,4 _7
4" to b"Transition: Length of Service: Final Cleanout:
Sump Pumps and Foundation Drains Notes
Sump Pumps Foundation Drains
Number: _J_ Number:
Number Discharged: Number ►scharged: I j L
Correctly _ Correctly
Incorrectly _ Incorrectly vf~= fiJ
/ Z/1 } r
Unknown Unknown
Further Investigation AV(, -r
0 No one home - left notice on door, i
Access to Service Lateral needed -
0 Cover replaced Time
U Obstruction ~'Ll. (rr j c vs f.. r< s 7' 7--
0 Review Videol0', / fL f r
White Copy: Property Owner Yellow Copy: City of Eagan l ( Pink Copy: SEH