2061 Emerald Lane - Inspection Form411 City of Ca aA
Residential Sanitary Sewer Service
Compliance Inspection
Date 4
Name
PID Number'
House Number
4" to 6" Transition:
dal
!
dwnerlOctiipgnt Signature
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
Service Lateral Inspection Findings
F 14
White Copy: Proper ty Owner
Time
Disk ##
..
am
pm
Street Name
Alternative Mailing Address Phone
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
Number of stacks f Entered S.L at
Yellow Copy: City of Eagan
Record Number
`f oam
2Time ) • fpm
1
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
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
1)
Length of Service: L.. Final Cleanout:
Pink Copy: SFH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Total
Sump pumps
' .4 � f;
Foundation drains
Roof drains
--
I — 2 7- 1 7t,
411 City of Ca aA
Residential Sanitary Sewer Service
Compliance Inspection
Date 4
Name
PID Number'
House Number
4" to 6" Transition:
dal
!
dwnerlOctiipgnt Signature
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
Service Lateral Inspection Findings
F 14
White Copy: Proper ty Owner
Time
Disk ##
..
am
pm
Street Name
Alternative Mailing Address Phone
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
Number of stacks f Entered S.L at
Yellow Copy: City of Eagan
Record Number
`f oam
2Time ) • fpm
1
inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
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
1)
Length of Service: L.. Final Cleanout:
Pink Copy: SFH