2066 Diffley Rd - Inspection FormCO of Ealan
Residential Sanitary Sewer Service
Compliance Inspection
Date -...S
Name ) L Disk #
MD Number
House Number C ✓ -? Street Name
Alternative Mailing Address
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4 No sump pump
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
y
y Transition 1 - ?
4" to 6 "Transition:
White Copy: Property Owner
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
Service Lateral Inspection Findings
Roots c',
am
Pm
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 � Entered S L. at
Length of Service: r.-)
Yellow Copy: City of Eagan
Record Number
Phone
2
r
inspector Signature
Obstruction
Unable to push past
feet.
• 7, am
• Pm
Final Cleanout:
Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Notes ;
- , 1, /n
; 7
1 t 7 ,_ `
/ - " � � ` - :-, -; ' ,
;� 7... ;
f r7
Total
Correctly
Incorrectly
Unknown
Sump pumps
%
Foundation drains
Roof drains
CO of Ealan
Residential Sanitary Sewer Service
Compliance Inspection
Date -...S
Name ) L Disk #
MD Number
House Number C ✓ -? Street Name
Alternative Mailing Address
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4 No sump pump
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
y
y Transition 1 - ?
4" to 6 "Transition:
White Copy: Property Owner
Owner /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
Service Lateral Inspection Findings
Roots c',
am
Pm
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 � Entered S L. at
Length of Service: r.-)
Yellow Copy: City of Eagan
Record Number
Phone
2
r
inspector Signature
Obstruction
Unable to push past
feet.
• 7, am
• Pm
Final Cleanout:
Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH