1535 Covington Lane - Inspection Form4 City of ko.
Residential Sanitary Sewer Service
Compliance Inspection
Date `- / I
•
MD Number
Time
-
Name
I-louse Number ) . j- % Street Name
Alter ative Mailing Address
Compliance
O No foundation drain connection
4 No roof drain connection
Sump pit not connected to
sanitary sewer
%o
p Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Mineral Deposits
Sag /Pipe Deflection -
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
Disk #
ner /Occupant Signature
am
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
Poor Pipe Joints
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
t
Phone ��-:::) !r / .
inspector Signature
For information call 651.470.2788
Unable to push past
feet
• { \ am
• '0 pm
Obstruction No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks . Entered S L at r r N '
..f Final Cleanout:
n
Notes
-6% ; I ILA
' r'
3
c ` l -r) / •
Pink Cor • SEH
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
1
Foundation drains
Roof drains
J
j
4 City of ko.
Residential Sanitary Sewer Service
Compliance Inspection
Date `- / I
•
MD Number
Time
-
Name
I-louse Number ) . j- % Street Name
Alter ative Mailing Address
Compliance
O No foundation drain connection
4 No roof drain connection
Sump pit not connected to
sanitary sewer
%o
p Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Mineral Deposits
Sag /Pipe Deflection -
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
Disk #
ner /Occupant Signature
am
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
Poor Pipe Joints
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
t
Phone ��-:::) !r / .
inspector Signature
For information call 651.470.2788
Unable to push past
feet
• { \ am
• '0 pm
Obstruction No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks . Entered S L at r r N '
..f Final Cleanout:
n
Notes
-6% ; I ILA
' r'
3
c ` l -r) / •
Pink Cor • SEH