2097 Jade Lane - Inspection Form111 City of hp
Residential Sanitary Sewer Service
Compliance Inspection
•nJ p am
Time ao pm
Disk # E 1 ETA
PID Number
Date l 4—JCL
Name
House Number
1
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints :
Mineral Deposits i s _.— 1 .,
Sag /Pipe Deflection ,,t=17
Damaged Pipe % i� ;r -.,-
Transition
4" to 6" Transition:
White Copy: Property Owner
4 Street Name
OwnerlOccupant Signature
Number of stacks
s ---
Phone ( l�� . fi;` 7 G "k
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:
[I]
Record Number
IT irne
Inspector Signature
Obstruction
Unable to push past
feet.
Entered S L. at
Final Cleanout:
O am
O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan )i,' '/ J674 j Pink Copy: SEH
Total
Number
Correctly
Discharged
Incorrectly
Unknown
N tes
� ` � � � } .. 6)
' l ,_`°.=' ,:___-_.--/if :
i i r
-71--
2 , (:. -'`" - -' 1
Sump pumps
Foundation drains
Roof drains
111 City of hp
Residential Sanitary Sewer Service
Compliance Inspection
•nJ p am
Time ao pm
Disk # E 1 ETA
PID Number
Date l 4—JCL
Name
House Number
1
Alternative Mailing Address
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints :
Mineral Deposits i s _.— 1 .,
Sag /Pipe Deflection ,,t=17
Damaged Pipe % i� ;r -.,-
Transition
4" to 6" Transition:
White Copy: Property Owner
4 Street Name
OwnerlOccupant Signature
Number of stacks
s ---
Phone ( l�� . fi;` 7 G "k
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:
[I]
Record Number
IT irne
Inspector Signature
Obstruction
Unable to push past
feet.
Entered S L. at
Final Cleanout:
O am
O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan )i,' '/ J674 j Pink Copy: SEH
Sewer Service
Compliance nspection
Residential Bana
Date / i Q
Name
i
PID Number
House Number
t?er /O
Roots 5 .f I
a
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition -
a
White Copy: Property Owner
ailing NAL_ ss Phone
For Information call 651.470.2788
Compliance
No foundation drain connection
o: No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
- c ,"1
4" to 6" Transition:
Time
J l .
! 1 7
�curp� Signature
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
c
Disk #
am
do pm
Street Name
Number of stacks
Length of Service:
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
fi
7 2
Correctly incorrectly Unknown
Record Number �r
"� - `-_ spector
Obstruction
Unable to push past
feet
ti
✓� 0
SJ
L
Time
R:
ignature
Entered S L. at i oi
1 1 -
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
/ •(
Final Cleanout:
Notes 1 .r,s /1, .
o am
o pm
•
Yellow Copy: City of Eagan Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551