2030 Shale Lane - Inspection Form
AW Residential Sanitary Sewer Se rvice
! E+ Compliance Inspection
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Date _1-1 I Time pm Record Number-
;
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Name Disk # r? /7 ? 1 f Time O Pm
PID Number
House Number- Street Name Alternative Mailing Address Phone 1~7 „1 l
OwnerlOccupont Signature Inspector Signature
For information call 651.470.2788
Co liance Non-Compliance Obstruction No Access
ANo foundation drain connection O Clear- water- connections to Unable to push past O No one in
ti sanitary sewer feet. O Access to service
No roof drain connection O Service lateral defects
lateral needed
O Sump pit not connected to O Defective manholes
sanitary sewer O Inspection
O Sump pump connected to sanitary refused
O Sump pump properly piped sewer
~No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number- of stacks ,Entered St at
r
Roots
Poor Pipejoints
Mineral Deposits. - - -
Sag/Pipe Deflection
Damaged Pipe
Transition -
4" to 6"Transition: Length of Service: %7 Final Cleanout:
Notes
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps f
Foundation drains yP
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH