4148 Topaz Dr - Inspection FormCity of km
Residential Sanitary Sewer Service
Compliance Inspection
Date 51 1 ) ! l Time • p
Name P ± / ��/pisk#t
PID Number
House Number )
Alternative Mailing Address
0 No sump pump
Roots
Poor Pipe joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
o pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
Street Name
Service Lateral Inspection Findings
Owner /Occupant Signature
Sag /Pipe Deflection
Damaged Pipe
Transition 2. i- - , /.,-- , 7 4797 L am` -"
I
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
Record Number
Phone
p am
Time_ — 7 • pm
'lnspectorgnature
For information call 651 .70.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L at ve ry'' ey
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: r 7'
2
Pink Copy: SEH
Number
Cor rectly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
X
Foundation drains
�e
Roof drains
Q
City of km
Residential Sanitary Sewer Service
Compliance Inspection
Date 51 1 ) ! l Time • p
Name P ± / ��/pisk#t
PID Number
House Number )
Alternative Mailing Address
0 No sump pump
Roots
Poor Pipe joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
o pliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
Street Name
Service Lateral Inspection Findings
Owner /Occupant Signature
Sag /Pipe Deflection
Damaged Pipe
Transition 2. i- - , /.,-- , 7 4797 L am` -"
I
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
Record Number
Phone
p am
Time_ — 7 • pm
'lnspectorgnature
For information call 651 .70.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L at ve ry'' ey
Length of Service:
Yellow Copy: City of Eagan
Final Cleanout: r 7'
2
Pink Copy: SEH