4168 Topaz Dr - Inspection FormCity of ha ar
Residential Sanitary Sewer Service
Compliance Inspection
Date ,0 /6 / l
Name J0,4
PID Number
House Number
Time (24-,go
Disk #
Street Name !3 Die
Alternative Mailing Address
j`Q No sump pump
White Copy: Property Owner
Owner /Occupant Signature
Com. pliance
c:PNIo foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4" to 6" Transition: / Kg/V1
0
e
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks ! Entered S.L at
Roots /0 ri
PoorPipeJoints
Mineral Deposits . 55( / (';f/ "'�
/ '
Sag /Pipe Deflection
Damaged Pipe �I
Transition ( 4A./ r'
I }
0
j Length of Service:
r .
Yellow Copy: City of Eagan
0
Record Number
017- .
Time 0
Obstruction
Unable to push past
feet
� .' 1 Inspector Signature
Final Cleanout:
.am
0 pm
Phone ,- MV)
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Notes
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
te r, -: °1
Roof drains
City of ha ar
Residential Sanitary Sewer Service
Compliance Inspection
Date ,0 /6 / l
Name J0,4
PID Number
House Number
Time (24-,go
Disk #
Street Name !3 Die
Alternative Mailing Address
j`Q No sump pump
White Copy: Property Owner
Owner /Occupant Signature
Com. pliance
c:PNIo foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
4" to 6" Transition: / Kg/V1
0
e
For information call 651.470.2788
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
Service Lateral Inspection Findings Number of stacks ! Entered S.L at
Roots /0 ri
PoorPipeJoints
Mineral Deposits . 55( / (';f/ "'�
/ '
Sag /Pipe Deflection
Damaged Pipe �I
Transition ( 4A./ r'
I }
0
j Length of Service:
r .
Yellow Copy: City of Eagan
0
Record Number
017- .
Time 0
Obstruction
Unable to push past
feet
� .' 1 Inspector Signature
Final Cleanout:
.am
0 pm
Phone ,- MV)
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH