4235 Moonstone Dr - Inspection Form4 111. City or Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Dateti's / / / 1 %0 Time // • o pm
Nam l f 1 // 11./ Disk #
PID Number
House Number yz _rs Street Name
Alternative Mailing Address
Ownelr /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
Q No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
0
0
0
0
0
Sag /Pipe Deflection
Damaged Pipe
Transition 1 / )
White Copy: Property Owner
c2
Non - Compliance
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
5(tr F -; i)
4" to 6 "Transition:Length of Service: .
Yellow Copy: City of Eagan
Record Number.
• t°� F7
�`am
Time / ' • • 3 O pm
Phone / T (6 - 4/
r
inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
Entered S at j Irf'-
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings
Roots - ' I
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Pink Copy: SEH
Number Discharged
Unknown
Notes f ,v/dc,, -„� -,,,t &{M{ f,7µ.
P �l5:,,i_, /";.,.. Fr ,�
3 -F
'°" I ' ,bar' f "�., 7 iv d,, " '� �' -�
JJ t- .. ;"6-7..., =
Total
Correctly
Incorrectly
Sump
Sump pumps
,J """....�.»,
_.------
�r F
Foundation drains
thl, 4.1 v AI_
Roof drains
4 111. City or Ea an
Residential Sanitary Sewer Service
Compliance Inspection
Dateti's / / / 1 %0 Time // • o pm
Nam l f 1 // 11./ Disk #
PID Number
House Number yz _rs Street Name
Alternative Mailing Address
Ownelr /Occupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
Q No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
0
0
0
0
0
Sag /Pipe Deflection
Damaged Pipe
Transition 1 / )
White Copy: Property Owner
c2
Non - Compliance
0
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
5(tr F -; i)
4" to 6 "Transition:Length of Service: .
Yellow Copy: City of Eagan
Record Number.
• t°� F7
�`am
Time / ' • • 3 O pm
Phone / T (6 - 4/
r
inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
Entered S at j Irf'-
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings
Roots - ' I
Poor Pipe Joints
Mineral Deposits
Final Cleanout:
Pink Copy: SEH