2114 Jade Lane - Inspection Form
Residential Sanitary Sewer Service.
City I Ir Compliance Inspection
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Date _ l ~ r 1 / Time p Prn Record Number 1
Name rC . L Disk # dr Time r /0 o Pm
PID Number
111_4Street Name
[-louse Number
Alternative Mailing Address Phone,'
y e
-
OwnerlOccupant Signature .l ✓ Inspector 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
sanitary sewer, feet O Access to service
No roof drain connection
O Service lateral defects lateral needed
O Sump pit not connected to 0- Defective manholes
O Inspection
sanitary sewer,
'10 Sump pump connected..so sanitary 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 C' f .
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to &"Transition: __eTngtl Service: 5+' Final Cleanout:~
Notes
Number Discharged
Total Correctly Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains - - - n
White Copy: Property Owner Yellow Copy: City of Eagan Pink Copy: SEH