2090 Quartz Lane - Inspection Form40P City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 G/ 1 � f �
�
Name
PID Number
House Number % i° / , Street Name
4" to 6" Transition:
White Copy: Property Owner
• 'Z' V am
Time 1 � • pm
Disk #
Owner /Occupant Signature
Compliance
,I
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Sag /Pipe Deflection
Damaged Pipe
'Transition
q
WIMP
Length of Service: —j
Yellow Copy: City of Eagan
Record Number
Time
'"
• 0 am
./ • pm
Alternative Mailing Address Phone I,.4
Inspec Signature
For information call 651.470.2788
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
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks '1 Entered S L at _ 5— = '.'1 :' ,!< , <i
Roots
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
7.).'
-�
Foundation drains
Roof drains
•'
40P City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 G/ 1 � f �
�
Name
PID Number
House Number % i° / , Street Name
4" to 6" Transition:
White Copy: Property Owner
• 'Z' V am
Time 1 � • pm
Disk #
Owner /Occupant Signature
Compliance
,I
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Sag /Pipe Deflection
Damaged Pipe
'Transition
q
WIMP
Length of Service: —j
Yellow Copy: City of Eagan
Record Number
Time
'"
• 0 am
./ • pm
Alternative Mailing Address Phone I,.4
Inspec Signature
For information call 651.470.2788
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
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks '1 Entered S L at _ 5— = '.'1 :' ,!< , <i
Roots
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH