2018 Jade Lane - Inspection FormSump pumps
0
Foundation drains
Roof drains
City of Ea i
Residential Sanitary Sewer Service
Compliance Inspection
Date 5/ / /
Name . I\/(/ Disk #
PID Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
1 No sump pump
Service Lateral Inspecti4 Findings
Roots ] r ]
Poor Pipe Joints
Mineral Deposits
S� g ipe Deflection
4" to 6 "Transition:
Time
Street Name
,A s
Owner /Occupant Signature
White Copy: Property Owner
J (I
• +0- 0 am
• pm
For information calf 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
Number of stacks Entered S.Lat
Damaged Pipe
s �
Transition s"
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
.
' Inspector Signature
Record Number
F_
• 9( ) O am
Time � • pm
J
Phone °' / 1 g4__
- - � 'r
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
s
3 Final Cleanout: ,-
Notes
Yellow Copy: City of Eagan Pink Copy: SEH