4273 Amber Dr - Inspection FormClay of Dm
Residential Sanitary Sewer Service
Compliance Inspection
%2 Date "7/ �� /
Name €,/ i ! , 1
AID Number
House Number 7 Street Name
r
Alter native Ma'lipgAddress
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
*i No sump pump
Poor Pipe Joints
4 4_0
4" to 6 "Transition:
1r
White Copy: Property Owner
Time f J pm
Owner /Occupanf,gnature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
//
Phone f
1
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
Obstruction
Unable to push past
feet
Time /C--/ • O pm
/ /
•
inspector Signature
For information call 65 1.470.2788 '?
Number of stacks ? Entered S.L. at
Service Lateral Inspection Findings
Roots
Length of Service:
Yellow Copy: City of Eagan
L
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
▪ Final Cleanout: i J!
Pink Copy: SEH
Number.
Correctly
Notes
Discharged
Total
Incorrectly
Unknown
Sump pumps
,•
Foundation drains
3i
Roof drains
(?
Clay of Dm
Residential Sanitary Sewer Service
Compliance Inspection
%2 Date "7/ �� /
Name €,/ i ! , 1
AID Number
House Number 7 Street Name
r
Alter native Ma'lipgAddress
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
*i No sump pump
Poor Pipe Joints
4 4_0
4" to 6 "Transition:
1r
White Copy: Property Owner
Time f J pm
Owner /Occupanf,gnature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
//
Phone f
1
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
Obstruction
Unable to push past
feet
Time /C--/ • O pm
/ /
•
inspector Signature
For information call 65 1.470.2788 '?
Number of stacks ? Entered S.L. at
Service Lateral Inspection Findings
Roots
Length of Service:
Yellow Copy: City of Eagan
L
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
▪ Final Cleanout: i J!
Pink Copy: SEH