2049 Bluestone Lane - Inspection FormsCity of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
, ,,8 \ No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time � 7 •
Disk #
( owner /Occupant Signature
O
O
O
O
O
1' am
O pm
7
PID Number
House Number i / Street Name
Alternative Mailing Address
Non - Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks /7 Entered S L at
Poor•PipeJoints
Mineral Deposits
S g /Pipe Deflection
Damaged Pipe
Transition
)
Length of Service: e,
Yellow Copy: City of Eagan
Record Number '1
i
•
Time •
Phone
Inspector Signature
Obstruction
Unable push past
feet.
l.� I ( .a d :�
O am
pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
1 `. , / mow
Final Cleanout: J j n
4 .mow /I /
Pink Copy: SEH
Total
N ) � �
e 3T.�
/ r .Y^
/ --; j 4
f - - - '. /
/
.� 1 /
f
.-- -_.J
,�
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
/
Foundation drains
Roof drains
City of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Date
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
, ,,8 \ No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Time � 7 •
Disk #
( owner /Occupant Signature
O
O
O
O
O
1' am
O pm
7
PID Number
House Number i / Street Name
Alternative Mailing Address
Non - Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks /7 Entered S L at
Poor•PipeJoints
Mineral Deposits
S g /Pipe Deflection
Damaged Pipe
Transition
)
Length of Service: e,
Yellow Copy: City of Eagan
Record Number '1
i
•
Time •
Phone
Inspector Signature
Obstruction
Unable push past
feet.
l.� I ( .a d :�
O am
pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Roots
1 `. , / mow
Final Cleanout: J j n
4 .mow /I /
Pink Copy: SEH
City of EaR,aii
Residential Sanitary Sewer Service
Compliance Inspection
Name ,
PO Number
- .J
4" to b "Transition:
House Number 1 °' Street Name
Alternative Mailing Address
QWn
11
No roof drain connection
'O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
White.Copy: Property Owner
• e.2-C am
Time • pm
Compliance
0 No foundation drain connection
Disk #
/Occupant Signature
Damaged Pipe
Transition
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Length of Service:
Record Number
Notes
{ am pv
Time . . pm
'1
Phone 6
- Efl
Inspector Signature
For information call 651:470.2788
Obstruction
Unable to push past
feet
Entered 5 L. at ._
-1 -'i Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Z I/
711.2
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
r . j
,�
Foundation drains
Roof drains
City of EaR,aii
Residential Sanitary Sewer Service
Compliance Inspection
Name ,
PO Number
- .J
4" to b "Transition:
House Number 1 °' Street Name
Alternative Mailing Address
QWn
11
No roof drain connection
'O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
White.Copy: Property Owner
• e.2-C am
Time • pm
Compliance
0 No foundation drain connection
Disk #
/Occupant Signature
Damaged Pipe
Transition
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
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Length of Service:
Record Number
Notes
{ am pv
Time . . pm
'1
Phone 6
- Efl
Inspector Signature
For information call 651:470.2788
Obstruction
Unable to push past
feet
Entered 5 L. at ._
-1 -'i Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Z I/
711.2
Yellow Copy: City of Eagan Pink Copy: SEH