1496 Thomas Lane - Inspection Form4111
City of p
Residential Sanitary Sewer Service
Compliance Inspection
Date o /!i /0
Name .A.,,A7 P) ..Jr° J// 4yr d Disk #
PID Number
House Number
Alter native Mailing Address
White Copy: Property Owner
Time . Q (} o pm
Street Name
Owner /Occupant Signature
J
Yellow Copy: City of Eagan
77 f
Record Number
77 o m
Time 0 7 : z o pm
P ne 74i) .s' r1'•7 - '/c''f
)
r 72r,�
• Inspector Sign ire
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
V y V Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
r
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Obstruction
Unable to push past
feet
Number of stacks l Entered S L at j' 4r /
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: ; t "p'
Final Cleanout:
Pink Copy: SEH
Total
Notes
1 7 r
, - e
L���_ r
art✓ rFr r3 , 1./ ' c ' , A,, -',°'( • ,--
,/ ) �(, : = s (1r j `! 4 3
F ,
sg� t t ��
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
i
Foundation drains
� '
Roof drains
f J
4111
City of p
Residential Sanitary Sewer Service
Compliance Inspection
Date o /!i /0
Name .A.,,A7 P) ..Jr° J// 4yr d Disk #
PID Number
House Number
Alter native Mailing Address
White Copy: Property Owner
Time . Q (} o pm
Street Name
Owner /Occupant Signature
J
Yellow Copy: City of Eagan
77 f
Record Number
77 o m
Time 0 7 : z o pm
P ne 74i) .s' r1'•7 - '/c''f
)
r 72r,�
• Inspector Sign ire
For information call 651.470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
V y V Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
r
Non - Compliance
O
O
O
O
O
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Obstruction
Unable to push past
feet
Number of stacks l Entered S L at j' 4r /
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service: ; t "p'
Final Cleanout:
Pink Copy: SEH