2030 Bluestone Lane - Inspection FormResidential Sanitary Sewer Service
City of Eap,an Compliance Inspection
Date $ 1 0X / /T✓ Time
Name j a /A) -5/1 f}(, iC \/ Disk #
PID Number
House Number Street Name 22 Z
� ,
Alternative Mailing Address /0 r "' �! �-- ° L. • 42 E5 P one 7 }.. , 1 7 .27" - 7
% c
t
P
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
t
• rr ,te
• r!G Q pm
0
5.
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
� k* Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks I Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits - Fr ! g S 1 l ( t °
Sag /Pipe Deflection 7 !. / i= r` - ,S - Sr-- - 1 -
Damaged Pipe C z.
Transition f l 1 v ni / (. ( ( /\J clfry 5
Length of Service:
White Copy: Property Owner IN: ; � t f Yellow Copy: City of Eagan
UNNoii 9 c) A. „ ,; 7 S
ti
Record Number
Time
Obstruction
Unable to push past
_feet
°: ar
1 v
fr Inspector Signature
O r a '
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: Z
Pink Copy: SEH
Number Discharged
Unknown
Notes - e.-9- y <--,, /"3i, r
�/
/ -4---'7D .l. ' `
< , °Gis" r2� ,'? S J
/O :, .. pis (-_ 1,•7, 7'
(,'; <,4- "l f .)(,. 3�s --,.
Total
Correctly
Incorrectly
Sump pumps
j 'n< l ,' ` /
Foundation drains
i -,(26/771/./:)
Roof drains!
_
_�_e._ ...._
_�____r_._._.W�_
J
Residential Sanitary Sewer Service
City of Eap,an Compliance Inspection
Date $ 1 0X / /T✓ Time
Name j a /A) -5/1 f}(, iC \/ Disk #
PID Number
House Number Street Name 22 Z
� ,
Alternative Mailing Address /0 r "' �! �-- ° L. • 42 E5 P one 7 }.. , 1 7 .27" - 7
% c
t
P
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6 "Transition:
Owner/Occupant Signature
Compliance
O No foundation drain connection
O No roof drain connection
t
• rr ,te
• r!G Q pm
0
5.
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
� k* Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks I Entered S.L at
Roots
Poor Pipe Joints
Mineral Deposits - Fr ! g S 1 l ( t °
Sag /Pipe Deflection 7 !. / i= r` - ,S - Sr-- - 1 -
Damaged Pipe C z.
Transition f l 1 v ni / (. ( ( /\J clfry 5
Length of Service:
White Copy: Property Owner IN: ; � t f Yellow Copy: City of Eagan
UNNoii 9 c) A. „ ,; 7 S
ti
Record Number
Time
Obstruction
Unable to push past
_feet
°: ar
1 v
fr Inspector Signature
O r a '
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: Z
Pink Copy: SEH