1513 Pinetree Pass - Inspection Form4 City of Ea all
Residential Sanitary Sewer Service
Compliance Inspection
Date_ 1 L J 9 Time
Name j 17 /1 (17) Disk #
PID Number
House Number
Alternative MailingAddress ,tx
( 1 2
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
/ Sump pump properly piped
0 No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 /r7/L ? /-''1
4" to 6" Transition:
White Copy: Property Owner
) i Street Name
OwnerlOccupant Signature
16 am
pm
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
Length of Service: l
Yellow Copy: City of Eagan
Record Number
Service Lateral Inspection Findings Number of stacks Entered S L at
Time
• am
Q pm
Phone ) 4777
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
r7
Inspector Signature
O Access to service
lateral needed
O Inspection
refused
()
Final Cleanout:
Pink Copy: SEH
Total
Notes
t
6,r = � 11 �� / ��
"��- — 7 ` f %,1
'7 � -�- 0
! ��1
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
!
J
fi
Foundation drains
(---
Roof drains
?
4 City of Ea all
Residential Sanitary Sewer Service
Compliance Inspection
Date_ 1 L J 9 Time
Name j 17 /1 (17) Disk #
PID Number
House Number
Alternative MailingAddress ,tx
( 1 2
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
/ Sump pump properly piped
0 No sump pump
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 /r7/L ? /-''1
4" to 6" Transition:
White Copy: Property Owner
) i Street Name
OwnerlOccupant Signature
16 am
pm
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
Length of Service: l
Yellow Copy: City of Eagan
Record Number
Service Lateral Inspection Findings Number of stacks Entered S L at
Time
• am
Q pm
Phone ) 4777
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
r7
Inspector Signature
O Access to service
lateral needed
O Inspection
refused
()
Final Cleanout:
Pink Copy: SEH