2073 Jade Lane - Inspection Formr E!ty of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
=1 . W ._._. : °°12(° am
Date 1 � 1 Time � pm
Name- )\h L==?/)
PID Number
I -louse Number
I )7- KCJ f l,+..x t_
Compliance
O No foundation drain connection
No roof drain connection
`` 0 Sump pit not connected to
sanitary sewer
O Surnp pump properly piped
/ ' No sump pump
Service Late 'al Ins
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
Owner /Occupant Signature
White Copy: Property Owner
`E Street Name
on Findings
■•
Disk #
17,
Non - Compliance
r 2
Alternative Mailing Address
Clear water connections to
sanitary sewer - ~� >6.2
O Service lateral de�cts
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Nu r e er of stacks
7
Length of Service:
Yellow Copy: City of Eagan
I 4,/j
Record Number
7
Time
Phone 1 H-5 -Lf 77
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
1 rte()). /
Final Cleanout:
o am
�"" � pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
tered S. L. at
Am
1; l < i4.5
ff Pink Copy: SEH
v4)
Number
Correctly
Discharged
of s
, �.
l ` ) (1 � --CY Y' �� r ( 7l ' t
T C + + .-7)�. ,-5171.) f�.,
r
.i
._ i 6T4-
Total
incorrectly
Unknown
Sump pumps
Foundation drains
'
Roof drains
r E!ty of Ea an
Residential Sanitary Sewer Service
Compliance Inspection
=1 . W ._._. : °°12(° am
Date 1 � 1 Time � pm
Name- )\h L==?/)
PID Number
I -louse Number
I )7- KCJ f l,+..x t_
Compliance
O No foundation drain connection
No roof drain connection
`` 0 Sump pit not connected to
sanitary sewer
O Surnp pump properly piped
/ ' No sump pump
Service Late 'al Ins
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
Owner /Occupant Signature
White Copy: Property Owner
`E Street Name
on Findings
■•
Disk #
17,
Non - Compliance
r 2
Alternative Mailing Address
Clear water connections to
sanitary sewer - ~� >6.2
O Service lateral de�cts
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Nu r e er of stacks
7
Length of Service:
Yellow Copy: City of Eagan
I 4,/j
Record Number
7
Time
Phone 1 H-5 -Lf 77
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
1 rte()). /
Final Cleanout:
o am
�"" � pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
tered S. L. at
Am
1; l < i4.5
ff Pink Copy: SEH
v4)