824 Wescott Square - Inspection Formt a p • p
Residential Sanitary Sewer Service
Compliance Inspection
Date /
Name
PIE) Number
House Number
Alternative M ilingAddress
>C�
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
/-� Disk ##
r Street Name
„,(w
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Proper ty Owner
Time
Owner /Occupant Signature
Service Lateral Inspection Findings
• 0 o.am
•
pm
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
Recor d Number.
of
I tk� .seFar+e - k 2c9 5
Time
•
o am
. V pm
Inspector gnature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks -I Entered S.L.at
- )1
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
, ! LA/f � , - ^°'' ` ' )
A '
J
i / e. a . r." '-' " l am' % - '! 1/1 �
Total
Sump pumps
,"
Foundation drains
X
Roof drains
0
t a p • p
Residential Sanitary Sewer Service
Compliance Inspection
Date /
Name
PIE) Number
House Number
Alternative M ilingAddress
>C�
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
/-� Disk ##
r Street Name
„,(w
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Proper ty Owner
Time
Owner /Occupant Signature
Service Lateral Inspection Findings
• 0 o.am
•
pm
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
Recor d Number.
of
I tk� .seFar+e - k 2c9 5
Time
•
o am
. V pm
Inspector gnature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Number of stacks -I Entered S.L.at
- )1
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH