2094 Jade Lane - Inspection FormCity al Fa as
Residential Sanitary Sewer Service
Compliance Inspection
Name
Transition
4" to 6 "Transition:
Compliance
No foundation drain connection
& I No roof drain connection
/§
Q Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Time
Service Lateral Inspection Findings
Disk #
PID Number
House Number / �° Street Name
Alternative Mailing Address
OwnerlOccupont Signature
Non - Compliance
O
O
O
0
0
Length
of Service:
For information call 651.470.2788
Clear water connections to
sanitar y sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks - 4 Entered S. L at ---
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Yellow Copy: City of Eagan
Record Number
Time t�� • o pm
Phone
Obstruction
Unable to push past
feet
ra•
Inspector Signature
Final Cleanout:
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
�4::,
' /:
' 2
71
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
,
Foundation drains
Roof drains
City al Fa as
Residential Sanitary Sewer Service
Compliance Inspection
Name
Transition
4" to 6 "Transition:
Compliance
No foundation drain connection
& I No roof drain connection
/§
Q Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Time
Service Lateral Inspection Findings
Disk #
PID Number
House Number / �° Street Name
Alternative Mailing Address
OwnerlOccupont Signature
Non - Compliance
O
O
O
0
0
Length
of Service:
For information call 651.470.2788
Clear water connections to
sanitar y sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks - 4 Entered S. L at ---
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Yellow Copy: City of Eagan
Record Number
Time t�� • o pm
Phone
Obstruction
Unable to push past
feet
ra•
Inspector Signature
Final Cleanout:
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH