2146 Shale Lane - Inspection Form(ay of to p
Residential Sanitary Sewer Service
Compliance Inspection
Date 614 12 4 .
_ r
Name " 97/ ( J'Disk #
PID Number
House Number
Alternative Mailing Address
For information calf 651.470.2788
Compliance
{
No foundation drain connection
'k t
No roof drain connection
*Sump pit not connected to
sanitary sewer
,& Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots 7/
Poor Pipe joints.
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
▪ 0 a
Time 6 (jam
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
7/, I
Length of Service:
u
Record Number
r,
Time
Phone :0—
, /`; Inspector Signature
Obstruction
Unable to push past
feet
Entered S Lat
° 7-7/— Final Cleanout:
Notes
o am
�
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEE'
Total
Number
Discharged
Cor rectly
Incorrectly
Unknown
Sump pumps
; \
Foundation drains
Roof drains
".....__ _
T
(ay of to p
Residential Sanitary Sewer Service
Compliance Inspection
Date 614 12 4 .
_ r
Name " 97/ ( J'Disk #
PID Number
House Number
Alternative Mailing Address
For information calf 651.470.2788
Compliance
{
No foundation drain connection
'k t
No roof drain connection
*Sump pit not connected to
sanitary sewer
,& Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots 7/
Poor Pipe joints.
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
▪ 0 a
Time 6 (jam
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
7/, I
Length of Service:
u
Record Number
r,
Time
Phone :0—
, /`; Inspector Signature
Obstruction
Unable to push past
feet
Entered S Lat
° 7-7/— Final Cleanout:
Notes
o am
�
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEE'