2094 Marble Lane - Inspection Form4 10Ik—
of Ia au
Residential Sanitary Sewer Service
Compliance Inspection
Date '
!
Name
Time 45: 0 Prn
/1-11_ <' 4/4eDisk #
PID Number
House Number Street Name
Alternative Mailing Address
Owner !Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Phone
r�-
J
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
Roots .;,C - ?tf - 1 r .
1 s r
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
� Y ;
Damaged Pipe
Transition
4" to 6" Transition � #
White Copy: Property Owner
i
/ i
_ j
Length of Service:
Yellow Copy: City of Eagan
0
Record Number %
tr-
�:
Time
.�:
•
Inspector Signature
Final Cleanout:
o am
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S L at `r-
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
!=
Roof drains
:t 7
4 10Ik—
of Ia au
Residential Sanitary Sewer Service
Compliance Inspection
Date '
!
Name
Time 45: 0 Prn
/1-11_ <' 4/4eDisk #
PID Number
House Number Street Name
Alternative Mailing Address
Owner !Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Phone
r�-
J
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks
Roots .;,C - ?tf - 1 r .
1 s r
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
� Y ;
Damaged Pipe
Transition
4" to 6" Transition � #
White Copy: Property Owner
i
/ i
_ j
Length of Service:
Yellow Copy: City of Eagan
0
Record Number %
tr-
�:
Time
.�:
•
Inspector Signature
Final Cleanout:
o am
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Entered S L at `r-
Pink Copy: SEH