1385 Grace Dr - Inspection Form401
City ill tagn
Residential Sanitary Sewer Service
Compliance Inspection
Date_ "\ 1 ,:5 / ;(,)
Name n ] Disk #
House Number
Alternative Mailing Address
27 pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
X Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
Time I(� pm
MD Number }
l Street Name
Owner /Occupant Signature
:s
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
6
Phone c' `
For information call 651.470.2788
Number of stacks Entered S L. at
Obstruction
Unable to push past
feet
Roots
Poor Pipe Joints
Mineral Deposits I } 11
(Slag/Pipe Deflection , t I r ` �
Damaged Pipe
Transition
Time
am
' • O prr
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Notes
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
X
111.
Foundation drains
Roof drains
401
City ill tagn
Residential Sanitary Sewer Service
Compliance Inspection
Date_ "\ 1 ,:5 / ;(,)
Name n ] Disk #
House Number
Alternative Mailing Address
27 pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
X Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
Time I(� pm
MD Number }
l Street Name
Owner /Occupant Signature
:s
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
6
Phone c' `
For information call 651.470.2788
Number of stacks Entered S L. at
Obstruction
Unable to push past
feet
Roots
Poor Pipe Joints
Mineral Deposits I } 11
(Slag/Pipe Deflection , t I r ` �
Damaged Pipe
Transition
Time
am
' • O prr
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH