2038 Emerald Lane - Inspection Form. it oI a an
Residential Sanitary Sewer Service
Compliance Inspection
r
Date
Name
PID Number
House Number �i Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
x 0 No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findi gs
Roots ; ,'
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition r
4" to 6 "Transition: Lzi
White Copy: Property Owner
•- o
Time ) • }�
Owner /Occupant Signature
7
am
pm
t"1
Non — Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
, r 1 �
• C. f et
Number of stacks 1 Entered S.L.at - i
Length of Service:
r i
/ 1 /
(
Yellow Copy: City of Eagan
Record Number
01)
J
Time `S •
Phone 4 � 4 2,)
"%
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout: -_
a 0 am
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
j j
Total
Notes
.-'' - '
K .-2 -
"-
r
�
`e_
I
n
� , ' -- - j ' � r
o i � r
7— . 2 - i ( "_ ��f! r ! 1
f / o M1 j (V) a .-�
% - f'
.4 5 r / -S' l 1 1
f '
; i
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
..-
Foundation drains
Roof drains
r
. it oI a an
Residential Sanitary Sewer Service
Compliance Inspection
r
Date
Name
PID Number
House Number �i Street Name
Alternative Mailing Address
For information call 651.470.2788
Compliance
x 0 No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findi gs
Roots ; ,'
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition r
4" to 6 "Transition: Lzi
White Copy: Property Owner
•- o
Time ) • }�
Owner /Occupant Signature
7
am
pm
t"1
Non — Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
, r 1 �
• C. f et
Number of stacks 1 Entered S.L.at - i
Length of Service:
r i
/ 1 /
(
Yellow Copy: City of Eagan
Record Number
01)
J
Time `S •
Phone 4 � 4 2,)
"%
inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout: -_
a 0 am
Pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
j j