2070 Emerald Lane - Inspection Form. 11 . 111. City ofEan a
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date 7l71 } i?
Name
PID Number
House Number t / Street Name
� `� i
Alternative Mailing Address Phone �. � � - 1 9 , .�.�
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
f oots
r s
4" to 6" Transition:
r
White Copy: Property Owner
`X /• am
Time / • / pm
Disk #
OwnerlOccupant Signature
Compliance
No foundation drain connection
No roof drain connection
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
For information call 651.470.2788
Number• of stacks E nter d S. .L at
a 5 �
Service Lateral Inspection Findings
Poor Epe oints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition )---) f' /' 4:
Length of Service:
Yellow Copy: City of Eagan
Record Number -1 /
Time 7• b
1
am
pm
Inspecr Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
final Cleanout: ' '""
_ / j 2/'
Pink Copy: SEH
Total
Notes
(911 -,! d
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
3
Foundation drains
Roof drains
Jar
. 11 . 111. City ofEan a
Y �
Residential Sanitary Sewer Service
Compliance Inspection
Date 7l71 } i?
Name
PID Number
House Number t / Street Name
� `� i
Alternative Mailing Address Phone �. � � - 1 9 , .�.�
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
f oots
r s
4" to 6" Transition:
r
White Copy: Property Owner
`X /• am
Time / • / pm
Disk #
OwnerlOccupant Signature
Compliance
No foundation drain connection
No roof drain connection
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
For information call 651.470.2788
Number• of stacks E nter d S. .L at
a 5 �
Service Lateral Inspection Findings
Poor Epe oints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition )---) f' /' 4:
Length of Service:
Yellow Copy: City of Eagan
Record Number -1 /
Time 7• b
1
am
pm
Inspecr Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
final Cleanout: ' '""
_ / j 2/'
Pink Copy: SEH