2079 Shale Lane - Inspection FormMks.
City lia as
Residential Sanitary Sewer Service
Compliance Inspection
D //2 m l /
Name
PID Number
House Number.
li • a m
me P
OwherlOccupant Signature
Compliance
No foundation drain connection
3.13c No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
P c - No sump pump
Service Lateral Inspection Findings
White Copy: Proper ty Owner
"2c2 77 Street Name
Non - Compliance
0
O
O
O
0
j 6
Clear• water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
4" to 6 " Transition: 1 ,, Length of Service:
Yellow Copy: City of Eagan
0
Record Number
1
_ e
• � am
Time l , • pm
Alternative Mailing Address Phone
Inspector Signature
For information call r
Obstruction
Unable to push past
feet
Final Clear
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L_ at 2 7777e: (
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Notes
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
M
--
Foundation drains
Roof drains
--
Mks.
City lia as
Residential Sanitary Sewer Service
Compliance Inspection
D //2 m l /
Name
PID Number
House Number.
li • a m
me P
OwherlOccupant Signature
Compliance
No foundation drain connection
3.13c No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
P c - No sump pump
Service Lateral Inspection Findings
White Copy: Proper ty Owner
"2c2 77 Street Name
Non - Compliance
0
O
O
O
0
j 6
Clear• water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
4" to 6 " Transition: 1 ,, Length of Service:
Yellow Copy: City of Eagan
0
Record Number
1
_ e
• � am
Time l , • pm
Alternative Mailing Address Phone
Inspector Signature
For information call r
Obstruction
Unable to push past
feet
Final Clear
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L_ at 2 7777e: (
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH