4282 Moonstone Dr - Inspection FormCity o f Eapo
Residential Sanitary Sewer Service
Compliance Inspection
Dat ' f ✓ 1 2
f✓ ;
Name
PID Number
House Number Street Name
Al er• Mailing Address
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
di No sump pump
PoorPipe joints
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
White Copy: Property Owner
Time
Disk #
OwnerlOcC7437thrSignature
Com pliance
No foundation drain connection
No roof drain connection
Total
,r h
Correctly
• ' o +am
• tEi pm
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 / ,. _ ' <� , r, ..... .�7 r_ ) ! f •— –,
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
Number Discharged
Incorrectly
Unknown
Record Number
Phone
11 Time
Entered S.L at
•
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
l Pinal Cleanout:
Notes I
-1 "
�.� � i .wry �•1� �, --� !
9 am
Pm
2
Yellow Copy: City of Eagan Pink Copy: SEH
4 0101 11
City of Eapil
Residential Sanitary Sewer Service
Compliance Inspection
Date /
Name
. / Disk #
r
PID Number
House Number
Alternative Address
—
Compliance
O No foundation drain connection
1
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral 1nSpection Findings
f
/
Roots
Poor Pipe Joints
Transition
4" to 6" Transition:
Time
.)\
1
Street Name
(3 2
Q wnerlOccupant Signature
For information call 651.470.2788
(-7.7
Mineral Deposits
I - -
g Pipe Deflection 41
Damaged Pip
White Copy Copy: Pr opet ty Owner
am
Pm
" 71
Non-Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump purnp connected to sanitary
sewer
O Flexible sump pump piping
Njimber of stacks
Record Number
otes
!2-/.
1'
r4 Time - •• am
Phone ...6, )— zip4
Inspector Signature
Obstruction
U7 push past
/,- feet
No Access
O No one in
O Access to service
lateral needed
o Inspection
refused
Entered S L at _ (
Length of Service: :1( / Final Cleanout:
17;
'{:111 L
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Correctly
Discharged
Incorrectly
Unknown
Sump pumps
Foundation drains
A
,."'
,
Roof drains
4 0101 11
City of Eapil
Residential Sanitary Sewer Service
Compliance Inspection
Date /
Name
. / Disk #
r
PID Number
House Number
Alternative Address
—
Compliance
O No foundation drain connection
1
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral 1nSpection Findings
f
/
Roots
Poor Pipe Joints
Transition
4" to 6" Transition:
Time
.)\
1
Street Name
(3 2
Q wnerlOccupant Signature
For information call 651.470.2788
(-7.7
Mineral Deposits
I - -
g Pipe Deflection 41
Damaged Pip
White Copy Copy: Pr opet ty Owner
am
Pm
" 71
Non-Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump purnp connected to sanitary
sewer
O Flexible sump pump piping
Njimber of stacks
Record Number
otes
!2-/.
1'
r4 Time - •• am
Phone ...6, )— zip4
Inspector Signature
Obstruction
U7 push past
/,- feet
No Access
O No one in
O Access to service
lateral needed
o Inspection
refused
Entered S L at _ (
Length of Service: :1( / Final Cleanout:
17;
'{:111 L
Yellow Copy: City of Eagan Pink Copy: SEH