4709 Pebble Beach Way - Inspection FormSump pumps j
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Roof drains ,
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City of tag,aa
Residential Sanitary Sewer Service
Compliance Inspection
Date f - / .j 1
Name 7 dcde rn
PID Number
House Number
Compliance
0 No foundation drain connection
0
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Transition' '
f +
4" to 6 "Transition:
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White Copy: Property Owner
Time g • ,p pm
Disk #
Owner /Occupant Signature
Street Name P iffe Tr/L.A./ t/4(
Alternative Mailing Address Phone % r�
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
Service Lateral Inspection Findings Number of stacks Entered S.L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection n r 7 �-
Damaged Pipe
L./
Length of Service: f'
Yellow Copy: City of Eagan
Record Number
• C) o am
Time • [fpm
I
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: , /51/4 ✓�i Fif
Total
Number Discharged
Correctly Incorrectly Unknown
Notes ,
-- O f ly !LW y ". l e.b i i
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r f r l4
Pink Copy: SETrI