3691 Windtree Dr - Inspection FormCity of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
Name
PID Number
Poor PipeJoints
Mineral Deposits
SaglPipe Deflection
4" to 6" Transition:
House Number
Alternative Mailing Address
t..f
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Ins ction Findings
Roots )(,-)
Damaged Pipe
1 e
Transition
White Copy: Property Owner
1
Time
Owner /Occupant Signature
Disk #
Street Name
f
Record Number
•
Time •
Phone
"1
O am
pm
lnspectoi Signature
For information call 651.470.2788
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:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Number of stacks I Entered S. at
d
f 1. Final Cleanout:
r r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
; : 'i , F
_.
f ' � � * %C Us ' •SC "". ,/' - i
/
Total
Sump pumps
w 7 r .
�
MI
MI
Foundation drains
MI
Roof drains
City of hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
Name
PID Number
Poor PipeJoints
Mineral Deposits
SaglPipe Deflection
4" to 6" Transition:
House Number
Alternative Mailing Address
t..f
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Ins ction Findings
Roots )(,-)
Damaged Pipe
1 e
Transition
White Copy: Property Owner
1
Time
Owner /Occupant Signature
Disk #
Street Name
f
Record Number
•
Time •
Phone
"1
O am
pm
lnspectoi Signature
For information call 651.470.2788
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:
Yellow Copy: City of Eagan
Obstruction
Unable to push past
feet
Number of stacks I Entered S. at
d
f 1. Final Cleanout:
r r
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH