684 Stonewood Rd - Inspection FormCif of a
Y g
Residential Sanitary Sewer Service
Compliance Inspection
Date_
PID Number
House Number K ' Street Name
Alterna ive Mai mg
l/
ddr•ess
Owner /Occupant Signature
Compliance
O No foundation drain connection
b No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
Transition
Time
Service Lateral Inspection Findings
Disk #
�1 am
pm
Number of stacks
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Le
Time
Phone f ! `/ ° ) 7 .!
For information call 651.470.2788
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at : .2 C11,0
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
}
Final Cleanout: ; r
Pink Copy: SEH
Notes
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Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
' _
,,i'
/_7'
J =
J
Foundation drains
' 1 : . - �.•
—
' 1
Roof drains
i
Cif of a
Y g
Residential Sanitary Sewer Service
Compliance Inspection
Date_
PID Number
House Number K ' Street Name
Alterna ive Mai mg
l/
ddr•ess
Owner /Occupant Signature
Compliance
O No foundation drain connection
b No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
Transition
Time
Service Lateral Inspection Findings
Disk #
�1 am
pm
Number of stacks
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
Le
Time
Phone f ! `/ ° ) 7 .!
For information call 651.470.2788
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at : .2 C11,0
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
}
Final Cleanout: ; r
Pink Copy: SEH