1397 Interlachen Dr - Inspection Form
s:
Residential Sanitary Sewer Service
City ! Ir Compliance Inspection
Date Time i' d Pm Record Number
am
b'flrlDisk# t Time 'd pm
N ame
~ ? ~ ~ ~ ~
PID Number._
House Number, _Street Name ' / 1 i 4
Alternative Mailing Address Phone i
OwnerlOccupant Signature Inspector Signature
For information call 651.470.2788
Comte pliance Non-Compliance Obstruction No Access
U No foundation drain connection O Clear water, connections to Unable to push past O No one in
No roof drain connection sanitary sewer _ feet_ O Access to service
O Service lateral defects lateral needed
O Sump pit not connected co O Defective manholes
sanitary sewer O Sump pump connected to sanitary O Inspection
refused
O Sump pump properly piped sewer,
No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number, of stacks Entered S L.at
Roots
Poor-Pipejoints
Mineral Deposits
Sag/Pipe Deflection _
Damaged Pipe
Transition
4" to 6" Transition: Length of Service: y' Final Cleanout:
j w
Notes
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH