2107 Shale Lane - Inspection Form4 `"
City lit Cap
Residential Sanitary Sewer Service
Compliance Inspection
Date Of 1- 0 1 /7
• 4am
Time /0 • o pm
s
Name M/' l i /' /, & `f Disk #
PID Number
House Number 2/02 Street Name
Alternative Mailing Address
Owner/Occupant Signature
il .
Compliance
No foundation drain connection
No roof drain connection
6 Sump pit not connected to
sanitary sewer
k / Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots ,7,
Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe , �, 1'" /
Transition 11/.1 i Lf.,1 :,,' (i ) ra
i r 1
4" to 6" Transition:
White Copy: Pr operty Owmer
0
1)//,' L,41J
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-
1
Entered St at
Time
Phone '7) 2 T
.`',inspector Signature
i
For information call 651.470.2788
Obstruction
Unable to push past
feet
" rr . k
r.
..
Length of Service: - Final Cleanout:
• am
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Notes
Total Correctly Incorrectly Unknown
Sump pumps
1 ®--
Foundation drains
1MM=
drains
/
-= Roof
4 `"
City lit Cap
Residential Sanitary Sewer Service
Compliance Inspection
Date Of 1- 0 1 /7
• 4am
Time /0 • o pm
s
Name M/' l i /' /, & `f Disk #
PID Number
House Number 2/02 Street Name
Alternative Mailing Address
Owner/Occupant Signature
il .
Compliance
No foundation drain connection
No roof drain connection
6 Sump pit not connected to
sanitary sewer
k / Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots ,7,
Number of stacks
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe , �, 1'" /
Transition 11/.1 i Lf.,1 :,,' (i ) ra
i r 1
4" to 6" Transition:
White Copy: Pr operty Owmer
0
1)//,' L,41J
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-
1
Entered St at
Time
Phone '7) 2 T
.`',inspector Signature
i
For information call 651.470.2788
Obstruction
Unable to push past
feet
" rr . k
r.
..
Length of Service: - Final Cleanout:
• am
• o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH