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4130 Nicols Rd - Inspection Form
City of tarn Residential Sanitary Sewer Service Compliance Inspection Date 04 ' 1d 7 I /o ?(_ //7 t2{'/ Name PID Number House Number Street Name Alternative Mailing Address For information call 651.470.2788 Compliance i © No foundation drain connection No roof drain connection O Sump pit not connected to sanitary sewer O Sump pump properly piped O No sump pump OwnerlOccupant Signature Service Lateral Inspection Findings Number of stacks a Entered St at Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection I : J Damaged Pipe Transition ie.. 4" to 6 "Transition: White Copy: Property Owner am Time 2 : f 0 pm (Disk # 0 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: Record Number zi -fr � ,� s , r am Time / • o pm P h on e( 0`J .` Fi / inspector Signature Obstruction Unable to push past feet Notes Final Cleanout: No Access O No one in O Access to service lateral needed O Inspection refused Aj i Yellow Copy: City of Eagan Pink Copy: SFH Total Number Discharged Correctly Incorrectly Unknown Sump pumps J =y Foundation drains ..w._......,. ...__ -• Roof drains _..__ __._ ..._ ___ City of tarn Residential Sanitary Sewer Service Compliance Inspection Date 04 ' 1d 7 I /o ?(_ //7 t2{'/ Name PID Number House Number Street Name Alternative Mailing Address For information call 651.470.2788 Compliance i © No foundation drain connection No roof drain connection O Sump pit not connected to sanitary sewer O Sump pump properly piped O No sump pump OwnerlOccupant Signature Service Lateral Inspection Findings Number of stacks a Entered St at Roots Poor Pipe Joints Mineral Deposits Sag /Pipe Deflection I : J Damaged Pipe Transition ie.. 4" to 6 "Transition: White Copy: Property Owner am Time 2 : f 0 pm (Disk # 0 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: Record Number zi -fr � ,� s , r am Time / • o pm P h on e( 0`J .` Fi / inspector Signature Obstruction Unable to push past feet Notes Final Cleanout: No Access O No one in O Access to service lateral needed O Inspection refused Aj i Yellow Copy: City of Eagan Pink Copy: SFH