2054 Diffley Rd - Inspection Forms` City of Eaga
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name A J 2 -fir
•
O . am
Time _ • C1' pm
Disk #
PID Number
LL-
Alternative Mailing Address Phone
House Number 2- Street Name
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
Owner /Occupant Signature
Number of stacks
Length of Service:
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
For information call 651 A70.2788
Obstruction
Unable to push past
feet
Entered S. L. at
Roots
Poor ?r7,4
Mine Deposits ; � ' ; „ "}
Sag /Pip /Deflection
Damaged Pipe
Transition
Notes
Time
f '
Inspector Signature
Final Cleanout:
• O am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
-
Foundation drains
Roof drains
II
` City of Eaga
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name A J 2 -fir
•
O . am
Time _ • C1' pm
Disk #
PID Number
LL-
Alternative Mailing Address Phone
House Number 2- Street Name
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
Owner /Occupant Signature
Number of stacks
Length of Service:
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
For information call 651 A70.2788
Obstruction
Unable to push past
feet
Entered S. L. at
Roots
Poor ?r7,4
Mine Deposits ; � ' ; „ "}
Sag /Pip /Deflection
Damaged Pipe
Transition
Notes
Time
f '
Inspector Signature
Final Cleanout:
• O am
O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
4 'City olF'a an
Residential Sanitary Sewer Service
Compliance Inspection
Date F /L ./ I 11
Name
Disk ##
PID Number
t '} ! _
House Number ,,.�` { :7) Street Name
Alternative Mailing Address
ff - OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection 0
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Transition
1 r 11
4" to 6 "Tran4ition:
White Copy: Property Owner
Time
`2(9,4 am
• 0 p
Non - Compliance
O
O
O
O
!1 r '
17 --44 --
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
r te
Length of Service: 7' 1
Yellow Copy: City of Eagan
Record Number
•
Time •
inspector Signature
Obstruction
Unable to push past
feet.
0
am
Am
Phone
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S,L at
Roots 7- I -�--
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Final Cleanout: e.
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
(; 1 if ' J .„,r / 1
/ � L:P/ / " ''l ) r.- x ()
li --)._L / ; I/ i ,� -, -,- r �---4 ( -�
i ..
r
Total
Sump pumps
{
,--q ,./ _.
-, 3 , 1 a
�,�
, , /5
/
Foundation drains
1
x
Roof drains
' 4
4 'City olF'a an
Residential Sanitary Sewer Service
Compliance Inspection
Date F /L ./ I 11
Name
Disk ##
PID Number
t '} ! _
House Number ,,.�` { :7) Street Name
Alternative Mailing Address
ff - OwnerlOccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection 0
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Transition
1 r 11
4" to 6 "Tran4ition:
White Copy: Property Owner
Time
`2(9,4 am
• 0 p
Non - Compliance
O
O
O
O
!1 r '
17 --44 --
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
r te
Length of Service: 7' 1
Yellow Copy: City of Eagan
Record Number
•
Time •
inspector Signature
Obstruction
Unable to push past
feet.
0
am
Am
Phone
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S,L at
Roots 7- I -�--
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Final Cleanout: e.
Pink Copy: SEH