2019 Zircon Lane - Inspection FormsSump pumps
' ,
Foundation drains
Roof drains
City of Ca an
Residential Sanitary Sewer Service
Compliance Inspection
Date / 2 }/_ lo./
Name ) / !` � . Disk #
aJ
PID Number
House Number
Alter native Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No roof drain connection
No sump pump
Service Lateral Inspection Findings
Roots �- — l -r
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - 7
) ` '(
4" to 6 "Transition:
White Copy: Pr operty Owner
Total
• o am
Time • , pm
Street Name
Owner /Occupant Signature
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
Number Discharged
Correctly
! r S
Number of stacks Entered S I_ at
l I
- I
Length of Service: ' j' ,? J , 1
1 1( Final Cleanout:
incorrectly Unknown
Record Number
Time • .6' pm
Phone �� = f � 1i 11
Inspector Signature
Obstruction
Unable to push past
feet
Notes
F
l '1 f
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
•
Yellow Copy: City of Eagan Pink Copy: SEH
City of laa
Res dentiai Sanitary Sewer Se viee
Compliance Inspection
Date 1 � 1 I
Name
V
PID Number
77
House Number
Alternative Mailing Address
For information call 651.470.2788
liance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Ti
No sump pump
Service Lateral Inspection Findings
Roots } =/
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6"Transition:
White Copy: Property Owner
Disk #
Time . u
Street Name
Owner/Occupant-Signature
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
Number of stacks
Yellow Copy: City of Eagan
Record Number �
Damaged Pipe
Transition 3 — =% ;2i''
Length of Service:
E
o cn
Time •
l
Phone _ /r . 1.
Inspector Signature
Obstruction
Unable to push past
feet
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Final Cleanout:
Pink Copy: SEH
Number.
Correctly
Discharged
Incorrectly
Unknown
s
otes i
-' I 1 --- 7 ,-- ,
�
_
= ' nom. _ :
(
}
7
1 f ' '.
'�'� �7 ` - i ,
IA, /=: ,`
_ / . 1!
Total
Sump pumps
Foundation drains
Roof drains
City of laa
Res dentiai Sanitary Sewer Se viee
Compliance Inspection
Date 1 � 1 I
Name
V
PID Number
77
House Number
Alternative Mailing Address
For information call 651.470.2788
liance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Ti
No sump pump
Service Lateral Inspection Findings
Roots } =/
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6"Transition:
White Copy: Property Owner
Disk #
Time . u
Street Name
Owner/Occupant-Signature
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
Number of stacks
Yellow Copy: City of Eagan
Record Number �
Damaged Pipe
Transition 3 — =% ;2i''
Length of Service:
E
o cn
Time •
l
Phone _ /r . 1.
Inspector Signature
Obstruction
Unable to push past
feet
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at
Final Cleanout:
Pink Copy: SEH