1472 Thomas Lane - Inspection FormsResidential Sanitary Sewer Service
Compliance Inspection
Date1 2 1 /,‘)
Name //41/j r l'`/4/24, Disk #
PID Number
House Number /7/7 Street Name
Alternative Mailing Address
'0/ -
O wnerlOccapa / t S
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
4" to 6" Transition:
White Copy: Pr operty Owner
•
Time •
O am
O pm
Length of Service:
Phone (?-12) 21 2 -22-7/
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 Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
::,
r
ik; V e
Yellow Copy: City of Eagan
Record Number
Time
f Spector Signature
Obstruction
Unable to push past
feet
• O am
• _ O Pm
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Number Discharged
Correctly
--
Incorrectly
--
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date1 2 1 /,‘)
Name //41/j r l'`/4/24, Disk #
PID Number
House Number /7/7 Street Name
Alternative Mailing Address
'0/ -
O wnerlOccapa / t S
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
4" to 6" Transition:
White Copy: Pr operty Owner
•
Time •
O am
O pm
Length of Service:
Phone (?-12) 21 2 -22-7/
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 Entered S L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Notes
::,
r
ik; V e
Yellow Copy: City of Eagan
Record Number
Time
f Spector Signature
Obstruction
Unable to push past
feet
• O am
• _ O Pm
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
.City of as
Residential Sanitary Sewer Service
Compliance Inspection
Date Oil c / /c'
Name . " ii ",j .44,4 Disk #
PID Number
House Number
Alternative Mailing Address
l - ! / �.
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
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe /
Transition • •/ A6-
4" to 6" Transition:
White Copy: Property Owner
•- O
Time //e( •_.C1 P
/V7 Street Name
OwnerfOccupant Signature
4
i"
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
Length of Service:
(/ o #(° °J
Yellow Copy: City of Eagan
Record Number
1 /1 Licl Time
/ F
%inspector Signature
Obstruction
Unable to push past
feet
6M .e(r
J
Number of sta;ks 1 , Entered S L. at ;7 (2. ,' 77;
Phone t..'% S ) r - '$"
Final Cl3 )
eaanout:
, /
•., pam
• :4rpm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
a
Pink Copy: SEH
Notes ��� - �'�- ,� f`'� � �4�� -.-.
_ .. ,, f , .,,, , 5 r
L) '
r. /44-
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
" _ -
r _ __
Foundation drains
-
_ -
Roof drains
'`
.City of as
Residential Sanitary Sewer Service
Compliance Inspection
Date Oil c / /c'
Name . " ii ",j .44,4 Disk #
PID Number
House Number
Alternative Mailing Address
l - ! / �.
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe /
Transition • •/ A6-
4" to 6" Transition:
White Copy: Property Owner
•- O
Time //e( •_.C1 P
/V7 Street Name
OwnerfOccupant Signature
4
i"
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Service:
(/ o #(° °J
Yellow Copy: City of Eagan
Record Number
1 /1 Licl Time
/ F
%inspector Signature
Obstruction
Unable to push past
feet
6M .e(r
J
Number of sta;ks 1 , Entered S L. at ;7 (2. ,' 77;
Phone t..'% S ) r - '$"
Final Cl3 )
eaanout:
, /
•., pam
• :4rpm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
a
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance Inspection
Date i2 _T/ 7 ? .1 a Time
Name ! /f , 4
4" to 6" Transition:
White Copy: Property Owner
Disk #
Owner /Occ(pat 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
O No sump pump
• Dam
• O pm
PID Number
House Number ./ / e Street Name r
Alternative Mailing Address Phone ( 2 )
For information call 65 1.470.2788
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 Entered S L,
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
• I P Spector Signature
Obstruction
Unable to push past
feet.
Final Cleanout:
• O am
• O pm
No Access
O No one in
j e.A Access to service
lateral needed
O inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
nknown
Incorrectly Unknown
Notes
-
° ° �{r ' °- l/ i [� / -- ? = ''"
i f ]�,
> (—
�r�:� ° .�'� / � %
Total
Sump pumps
Foundation drains
Roof drains
--
Residential Sanitary Sewer Service
Compliance Inspection
Date i2 _T/ 7 ? .1 a Time
Name ! /f , 4
4" to 6" Transition:
White Copy: Property Owner
Disk #
Owner /Occ(pat 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
O No sump pump
• Dam
• O pm
PID Number
House Number ./ / e Street Name r
Alternative Mailing Address Phone ( 2 )
For information call 65 1.470.2788
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 Entered S L,
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
• I P Spector Signature
Obstruction
Unable to push past
feet.
Final Cleanout:
• O am
• O pm
No Access
O No one in
j e.A Access to service
lateral needed
O inspection
refused
Pink Copy: SEH