2098 Quartz Lane - Inspection FormCity at as
Residential Sanitary Sewer Service
Compliance Inspection
Date / 0 / ! f /
Transition
PID Number
House Number i `" / Street Name
Alternative Mailing Address
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
P Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findi
Roots . -``?
PoorPipe)oints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to 6 " Transition:
White Copy: Property Owner
Owner /Occupant Signature
1 "•
G • i--' p am
Time ) • ,0( 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
1 Number of stacks 1 Entered S . at.3
4
// i 2 '
Length of Service:
Yellow Copy: City of Eagan
i I
Record Number
:, •, — am
Time _ • pm
Phone
Obstruction
Unable to push past
feet
/r
es 14-
1'
Inspector Signature
No Access
O No one in
71
Final Cleanout:
O Access to service
lateral needed
O Inspection
re €used
Pink Copy: SEH
• Number Discharged
Notes
. /� , ? J = '� i"-1 r l i'�— i - -ir
t i j " i ' ' '..: 7 1
�}— 1
t jlz-1 l /
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
; 1
City at as
Residential Sanitary Sewer Service
Compliance Inspection
Date / 0 / ! f /
Transition
PID Number
House Number i `" / Street Name
Alternative Mailing Address
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
P Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findi
Roots . -``?
PoorPipe)oints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
4" to 6 " Transition:
White Copy: Property Owner
Owner /Occupant Signature
1 "•
G • i--' p am
Time ) • ,0( 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
1 Number of stacks 1 Entered S . at.3
4
// i 2 '
Length of Service:
Yellow Copy: City of Eagan
i I
Record Number
:, •, — am
Time _ • pm
Phone
Obstruction
Unable to push past
feet
/r
es 14-
1'
Inspector Signature
No Access
O No one in
71
Final Cleanout:
O Access to service
lateral needed
O Inspection
re €used
Pink Copy: SEH