2046 Bluestone Lane - Inspection FormCity or hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 / /t
Name 77„6" - {r frti /� iJ
PID Number
House Number ZO
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
OwnerlOccupant Signature
White Copy: Property Owner
Time c� :i,U 6 p
Disk #
0
AO
Street Name C f,<e car"
Alternative Mailing Address Phone i ir/2— ° 7 r`
f --/ Inspector Signature
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
R C am
Cr) Time
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks l` r
. / Entered S.L at - %
Roots /
Poor Pipe joints
Mineral Deposits
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
G'f/ /Lx Ll ter'
Final Cleanout: cpi/<4,04./
Pink Copy: SEH
Number
Correctly
Discharged
Notes ( 4'7rre y J ec ' ,-�rv.
( (,..,. .-V d 'Xi y ,
Total
Incorrectly
Unknown
Sump pumps
r n.
_ _
.._..�__
Foundation drains
/
Roof drains
_
��
. ��
City or hp
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 / /t
Name 77„6" - {r frti /� iJ
PID Number
House Number ZO
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
OwnerlOccupant Signature
White Copy: Property Owner
Time c� :i,U 6 p
Disk #
0
AO
Street Name C f,<e car"
Alternative Mailing Address Phone i ir/2— ° 7 r`
f --/ Inspector Signature
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
R C am
Cr) Time
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks l` r
. / Entered S.L at - %
Roots /
Poor Pipe joints
Mineral Deposits
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
G'f/ /Lx Ll ter'
Final Cleanout: cpi/<4,04./
Pink Copy: SEH