1509 Pinetree Pass - Inspection FormSump pumps
Foundation drains
Roof drains
—____._..._.-
4411110.
4:14 liapn
Residential Sanitary Sewer Service
Compliance Inspection
Date ZZ / ,J
Name " ?./ ? /Ta i"Z•E E"' Disk #
PID Number
House Number
Alternative Mailing Address
{ �F
Owner /Occupant Signature
For information call 651.470.2788
Compliance
0 No foundation drain connection
No roof drain connection
id Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
4" to 6" Transition:
White Copy: Proper ty Owner
Q 7 •dca (afam
Time • o pm
0
Street Name
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
t
Number of stacks
SaglPipe Deflection
Damaged Pipe
Transition ` " ' ' ' r> ` t -
Length of Service: /69 e
Number Discharged
al Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Entered S..L, at 2, 2
Phone
J �
1
Inspector Signature
Final Cleanout: --
_) r
• — o 4
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes Z47,A =�
Pink Copy: SEH