2090 Jade Lane - Inspection Form
Residential Sanitary Sewer Service
Compliance Inspection
Record Number
Date1?1 Time '1 o PM
Name ? J~ Disk # i Time • o pm
PID Number'
House Number Street Name ! ZIXI
Alternative Mailing Address Phone
r - An . ~t f
OwnerlQccupant Signature r lns¢ector Signature
For information call 651.470.2788
Compliance Non-Compliance Obstruction No Access
No foundation drain connection O Clear- water, connections to Unable to push past O No one in
O No roof drain connection sanitary sewer _ feet O Access to service
O Service lateral defects lateral needed
O Sump pit not conriected to O Defective manholes
sanitary sewer O Sump pump connected to sanitary O Inspection
Sump pump properly piped sewer, refused
No sump pump O Flexible sump pump piping
Service Lateral Inspection Findings Number- ofstacks I Entered S.L at -kjrc,g_ 610
Roots
Poor Pipe Joints
ineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition L I B f l/vy ~ - J r
4" to 6" Transition: Length of Service:' Final Cleanout:
Notes
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps
Foundation drains _ w
Roof drains -
White Copy: Property Owner n Yellow Copy: City of Eagan Pink Copy: SEH