1616 Covington Lane - Inspection FormCity of bp
Residential Sanitary Sewer Service
Compliance Inspection
Date__ / Time
Name
PID Number
House Number
Alternative Mailing Address
Owner /Occupant SignatuVe
For information call 651.470.2788
Compliance
O No foundation drain connection
t iq
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
No roof drain connection
Service Lateral Inspection Findings
Roots
PoolPipeJ•l f
Miner! ! eposits
Sag pe;Deflection
Damaged Pipe
4" to 6" Transition:
White Copy: Property Owner
Disk #
Street Name
am
pm
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
Yellow Copy: City of Eagan
L/ 7 ri )/~T/ a
Length of Service:
Record Number - 7
Phone
/ r
" 2
/
Obstruction
Unable to push past
feet
Entered S.L. at
am
Time fe • � o pm
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Transition
Pink Copy: SE
Number Discharged
Correctly Incorrectly
Unknown
Notes
Total
Sump pumps
`
---
MEI
Foundation drains
Roof drains
City of bp
Residential Sanitary Sewer Service
Compliance Inspection
Date__ / Time
Name
PID Number
House Number
Alternative Mailing Address
Owner /Occupant SignatuVe
For information call 651.470.2788
Compliance
O No foundation drain connection
t iq
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
No roof drain connection
Service Lateral Inspection Findings
Roots
PoolPipeJ•l f
Miner! ! eposits
Sag pe;Deflection
Damaged Pipe
4" to 6" Transition:
White Copy: Property Owner
Disk #
Street Name
am
pm
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
Yellow Copy: City of Eagan
L/ 7 ri )/~T/ a
Length of Service:
Record Number - 7
Phone
/ r
" 2
/
Obstruction
Unable to push past
feet
Entered S.L. at
am
Time fe • � o pm
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Transition
Pink Copy: SE