2116 Shale Lane - Inspection FormsResidential Sanitary Sewer Service
41. City i1 EagnCompliance Inspection
Date ""/ / 1 ../ Time
Name
Disk#L
PID Number
House Number ) Street Name
p
m
Record Number ='
m—mu.-.
1_
O am
•
• O pm
Alternativ ailing Address Phone
Ownerfrrupant Signature
Inspector Signature
�J/
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Non -Compliance
O Clear. waterconnections to
sanitary sewer.
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Obstruction
Unable to push past
feet
No Access
0 No in
Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S . at
Roots
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
Length of Service:
Final Cleanout:
White Copy: Property Owner
Yellow Copy: City of Eagan
Pink Copy: SEH
9tes
4--f
2_=.Sump �" �r
�. �
__..1-,---j---/)..„----C-1—
`� -- '- __--,
� `' f
:1, r i %._::` -.a.:-.---,;,::::4-s.---e-.1:,f
�., i / + ^ r
yf` �,_,'
Number
CorrectlyIncorrect,
Discharged
Unknown
Total
pumps
Foundation drains
Roof drains
White Copy: Property Owner
Yellow Copy: City of Eagan
Pink Copy: SEH
4116111-
Ey of Ia an
Residential Sanitary Sewer Service
Compliance Inspection
Date / f
Name
.6 2 O am
Time 4.40 pm
Disk #
PID Number
Record Number
Time
House Number / i r Street Name▪ .
:- —3
Alternative Mailing Address`s l%/% '/%Y
Owner/Occupant Signature
0 am
pm
Inspector Signature
For information call 651.470.2788
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
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
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings _ Number of stacks 'f Entered S Lat
Roots/7L
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
1
Transition -f -. tc1
r,2
i
'r .--"/" j l
4" to 6" Transition:
Length of Ser vice:
Final Cleanout: 17
White
Notes
Number
Correctly
Discharged
incorrectly
Unknown
Total
Sump pumps
,,. l,'
Foundation drains
�i
Roof drains
/1
(..,.--
��
White Copy: Property Owner
Yellow Copy: City of Eagan
Pink Copy: SEH