2128 Jade Pt - Inspection Form4110. city F Ea a[I
Residential Sanitary Sewer Service
Compliance Inspection
Date 2.--7- - 1 1 /
Name ) -''� `. Disk #
v
PID Number
f1 / /
House Number / _Street Name
Poor Pipe Joints
4" to 6" Transition:
Alternative Mailing Address
, (4.
Owner1Occ6 nt Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
White Copy: Pr operty Owner
•
Time •
Z(34 aril
pm
Service Lateral Inspection Findings Number of stacks
Roots
, �
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
inspect r gnature
Obstruction
Unable to push past
feet
•� am
• o prn
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at T ��r� ' s •
Final Cleanout: j
, r
' f 3
Pink Copy: SEH
Total
Notes .-'
2 _5-----/--) b(b s� ' —
-,/1 a /t ..1 ' = i.. ni• )
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
X
Foundation drains
,2
Roof drains
4110. city F Ea a[I
Residential Sanitary Sewer Service
Compliance Inspection
Date 2.--7- - 1 1 /
Name ) -''� `. Disk #
v
PID Number
f1 / /
House Number / _Street Name
Poor Pipe Joints
4" to 6" Transition:
Alternative Mailing Address
, (4.
Owner1Occ6 nt Signature
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
White Copy: Pr operty Owner
•
Time •
Z(34 aril
pm
Service Lateral Inspection Findings Number of stacks
Roots
, �
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
inspect r gnature
Obstruction
Unable to push past
feet
•� am
• o prn
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L at T ��r� ' s •
Final Cleanout: j
, r
' f 3
Pink Copy: SEH