2018 Shale Lane - Inspection FormCity at Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date (237 /_ 1 ✓
Name --
Alternative Mailing Address
�frl�J
Compliance
No foundation drain connection
No roof drain connection
)S Sump pit not connected to
sanitary sewer
;O- Sump pump properly piped
0 No sump pump
White Copy: Property Owner
r • 0 a
Time i • _.i 6, pm
PID Number
.ry
House Number er' - /-Y Street Name
OwnerlOccupar?t'Sig
Transition ( ' { ( /,-L ,/,,,,et,- �y �f^
ill it,/ itt ^ati j f "", /Ai 0 01- ( 6 4 - P " -.
r /
4" to 6" Transition: A..1/A
C,
3
Sag /Pipe Deflection
Damaged Pipe _ /
CI
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 Findings Number of stacks Entered S L at -.) 7' // V t'
'V/ tP
Roots _.) i .-..
Poor Pipe Joints
Mineral Deposits
Length of Service:
Yellow Copy: City of Eagan
C}
Record Number
I
I w�
Time
4
Phone !t
/ /
inspector Signature
Obstruction
Unable to push past
feet
O am
fpm
-.1 f a
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
F
Final Cleanout:
Pink Copy: SEH
Total
Notes
y
' f � {
e ! /.! / :J
)
d ' ,r
_" ` ;r` j
S ; r c ✓{
1.1:
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
i
Foundation drains
..__
Roof drains
,
City at Ea
Residential Sanitary Sewer Service
Compliance Inspection
Date (237 /_ 1 ✓
Name --
Alternative Mailing Address
�frl�J
Compliance
No foundation drain connection
No roof drain connection
)S Sump pit not connected to
sanitary sewer
;O- Sump pump properly piped
0 No sump pump
White Copy: Property Owner
r • 0 a
Time i • _.i 6, pm
PID Number
.ry
House Number er' - /-Y Street Name
OwnerlOccupar?t'Sig
Transition ( ' { ( /,-L ,/,,,,et,- �y �f^
ill it,/ itt ^ati j f "", /Ai 0 01- ( 6 4 - P " -.
r /
4" to 6" Transition: A..1/A
C,
3
Sag /Pipe Deflection
Damaged Pipe _ /
CI
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 Findings Number of stacks Entered S L at -.) 7' // V t'
'V/ tP
Roots _.) i .-..
Poor Pipe Joints
Mineral Deposits
Length of Service:
Yellow Copy: City of Eagan
C}
Record Number
I
I w�
Time
4
Phone !t
/ /
inspector Signature
Obstruction
Unable to push past
feet
O am
fpm
-.1 f a
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
F
Final Cleanout:
Pink Copy: SEH