2005 Emerald Lane - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date - 3 /,° / r(
Name ! :i
PO Number.
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Disk #
OwnerlOccupant Signature
Service Lateral Inspection Findings
Roots i
Roof drains
Time ( 4 p
.te
4" to 6" Transition:
rr
White Copy: Property Owner
Street Name
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
NNumller' of stacks
Length of Service:
Number Discharged
Sump pumps
Foundation drains
Total
Correctly Incorrectly Unknown
Record Number
Phone
/ Inspector Signature
Notes
f oam
Time • c pm
Obstruction
Unable to push past
feet
Entered S.L.at
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
}
Transition
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
. 7l
� I
Final Cleanout: � `-7 ' , -
Yellow Copy: City of Eagan Pink Copy: SEH