2104 Emerald Lane - Inspection Form...City of Ea aii
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 )(: / }('
Name
PID Number
House Number 2 )7 ? 21. Street Name
w ,
LL
/yi
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 ` a .
4" to 6" Transition:
White Copy: Property Owner
am
Time )/
Ow ) er /Occupant Signature
Disk #
Pm
Alternative Mailing Address
For information call 651.470.2788
Non - Compliance
O Clean 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
Length of Service:
Entered ST at
l
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
}
Transition ` l i /, y�. ! tea?✓
Yellow Copy: City of Eagan
Record Number '
r"�
) � -7----) d am
Time / v • O pm
Phone r/7
I Y
'inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Tot
Notes
/ _ ; , ,
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/
/-a tO,a=— 1 X44 /)
, ( �
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i
ff
Number
Discharged
Correctly
Incorrectly .Unknown
Sump pumps
1
.
Foundation drains
Roof drains
...City of Ea aii
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 )(: / }('
Name
PID Number
House Number 2 )7 ? 21. Street Name
w ,
LL
/yi
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 ` a .
4" to 6" Transition:
White Copy: Property Owner
am
Time )/
Ow ) er /Occupant Signature
Disk #
Pm
Alternative Mailing Address
For information call 651.470.2788
Non - Compliance
O Clean 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
Length of Service:
Entered ST at
l
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
}
Transition ` l i /, y�. ! tea?✓
Yellow Copy: City of Eagan
Record Number '
r"�
) � -7----) d am
Time / v • O pm
Phone r/7
I Y
'inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH