4729 Pebble Beach Way - Inspection FormCity of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
' No sump pump
4" to 6" Transition:
White Copy: Property Owner
Time
Service Lateral inspection Findings
Disk #
Owner /Occupant Signature
"11/20 0 am
• Pm
Street Name
Yellow Copy: City of Eagan
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:
Record Number f
o am
ime
Obstruction
Unable to push past
feet
Number of stacks -1
Entered S.L at7
fnspedor Lure
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe /
Transition
Final Cleanout:
r
774 !7
Pink Copy: SEH
Number Discharged
Notes
Total
Correctly
Incorrectly Unknown
Sump pumps
` )
Foundation drains
Roof drains
.' 1
City of Ea au
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
' No sump pump
4" to 6" Transition:
White Copy: Property Owner
Time
Service Lateral inspection Findings
Disk #
Owner /Occupant Signature
"11/20 0 am
• Pm
Street Name
Yellow Copy: City of Eagan
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:
Record Number f
o am
ime
Obstruction
Unable to push past
feet
Number of stacks -1
Entered S.L at7
fnspedor Lure
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe /
Transition
Final Cleanout:
r
774 !7
Pink Copy: SEH