2127 Shale Lane - Inspection Formcity bpi
Residential Sanitary Sewer Service
Compliance Inspection
Date , 1.. / )C1'
Name
PID Number
House Number 1 Street Name
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots 3 6--
S Deflection
Damaged Pipe
{ 5 A
Transition ,LL �.
4" to 6" Transition:
White Copy: Property Owner
• . S(9O am
Time 1 • • pm
1
OwnerfOccupant Signature
Disk #
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
Number of stacks
-T-
Length of Service:
Yellow Copy: City of Eagan
Record Number `f
Alternative Mailing Address Phone
ime
n
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S. L at
Poor Pipe Joints
Mineral Deposits
r
/ . -Final Cleanout:
X71 0 a
• f P
m
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Unknown
Notes i
t � : a ��� % ,' -i - ,� a
r,l i
1 r2 / J 7e-
r
Total
Correctly
Incorrectly
Sump pumps
Foundation drains
R,)
Roof drains
city bpi
Residential Sanitary Sewer Service
Compliance Inspection
Date , 1.. / )C1'
Name
PID Number
House Number 1 Street Name
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots 3 6--
S Deflection
Damaged Pipe
{ 5 A
Transition ,LL �.
4" to 6" Transition:
White Copy: Property Owner
• . S(9O am
Time 1 • • pm
1
OwnerfOccupant Signature
Disk #
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
Number of stacks
-T-
Length of Service:
Yellow Copy: City of Eagan
Record Number `f
Alternative Mailing Address Phone
ime
n
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S. L at
Poor Pipe Joints
Mineral Deposits
r
/ . -Final Cleanout:
X71 0 a
• f P
m
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH