4760 Westminster Cir - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
I (,
Date 1
Name
Poor Pipe Joints
4" to 6 "Transition:
Compliance
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 Inspection Findings
Roots
White Copy: Property Owner
Time
1 ,
isk #
PID Number
House Number �,1 Street Name
/I fl
�ry am
0 pm
O wnerlOccupa9 Signa
Yellow Copy: City of Eagan
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
Record Number
Alternative Mailing Address Phone r A
Number of stacks Entered St. at
1
Length of Service: ) r1-
Time i
Obstruction
Unable to push past
feet
inspector Signature
am
Pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 44
Final Cleanout:�
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
..•-�.
1
., -.
,. i'' `,
_a 1
3 /
_ mil /
Foundation drains
f
Roof drains
t
Residential Sanitary Sewer Service
Compliance Inspection
I (,
Date 1
Name
Poor Pipe Joints
4" to 6 "Transition:
Compliance
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 Inspection Findings
Roots
White Copy: Property Owner
Time
1 ,
isk #
PID Number
House Number �,1 Street Name
/I fl
�ry am
0 pm
O wnerlOccupa9 Signa
Yellow Copy: City of Eagan
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
Record Number
Alternative Mailing Address Phone r A
Number of stacks Entered St. at
1
Length of Service: ) r1-
Time i
Obstruction
Unable to push past
feet
inspector Signature
am
Pm
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 44
Final Cleanout:�
Pink Copy: SEH