2021 Jade Lane - Inspection FormCity l
Y Eaau
Residential Sanitary Sewer Service
Compliance Inspection
Date_ / j 7 / )r` Time
Name
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
ompliance
No foundation drain connection
f p No roof drain connection
o Sump pit not connected to
sanitary sewer
o Sump pump properly piped
f C No sump pump
White Copy: Pr operty Owner
1
Disk #
Street Name
OwnerlQccupant Signature
• )1R1 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
Yellow Copy: City of Eagan
Record Number
Time
Phone '��
Service Lateral Inspection Findings Number of stacks I Entered S L at
Roots_ -
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition / `y717 - " ° .3 Cam. ¢ !O ) L .
Length of Service: /
lnspectoiSignature
Final Cfeanout:
t
am
Pm
Obstruction No Access
Unable to push past 0 No one in
feet
For information call 651.470.2788
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
)
Foundation drains
Roof drains
s'
City l
Y Eaau
Residential Sanitary Sewer Service
Compliance Inspection
Date_ / j 7 / )r` Time
Name
PID Number
House Number
Alternative Mailing Address
4" to 6" Transition:
ompliance
No foundation drain connection
f p No roof drain connection
o Sump pit not connected to
sanitary sewer
o Sump pump properly piped
f C No sump pump
White Copy: Pr operty Owner
1
Disk #
Street Name
OwnerlQccupant Signature
• )1R1 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
Yellow Copy: City of Eagan
Record Number
Time
Phone '��
Service Lateral Inspection Findings Number of stacks I Entered S L at
Roots_ -
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition / `y717 - " ° .3 Cam. ¢ !O ) L .
Length of Service: /
lnspectoiSignature
Final Cfeanout:
t
am
Pm
Obstruction No Access
Unable to push past 0 No one in
feet
For information call 651.470.2788
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH