4631 Cambridge Dr - Inspection FormCity of Eipa
Residential Sanitary Sewer Service
Compliance Inspection
Date 4 l L D'
f
Name
P1D Number
House Number ; i- / Street Name
l`'�' " "1���i'
Phone' �°°- 4- ,. : : 1: r 7 C .- /(
Alternative Mailing Address ,-�
Compliance
$ No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O. Sump pump properly piped
0 No sump pump
1 !/ Disk ti
Ownerttrtrrprmt- Segature
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
White Copy: Property Owner
°•
Time •
/ . j
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
Poor•PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - _
c/ 2 , _ 1,. - ✓_: ' - --,1 f � • 2 ,, -t- / . = --- } r
4" to 6 "Transition: Length of Service: i ;`
Yellow Copy: City of Eagan
Record Number
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S L at
am
Time • o pm
Inspector Signature
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
),..--2-,,,,, , s : e ; .,-
/;
, 1,.' y ;
c- 1
Total
Sump pumps
]
Foundation drains
Roof drains
City of Eipa
Residential Sanitary Sewer Service
Compliance Inspection
Date 4 l L D'
f
Name
P1D Number
House Number ; i- / Street Name
l`'�' " "1���i'
Phone' �°°- 4- ,. : : 1: r 7 C .- /(
Alternative Mailing Address ,-�
Compliance
$ No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O. Sump pump properly piped
0 No sump pump
1 !/ Disk ti
Ownerttrtrrprmt- Segature
For information call 651.470.2788
Service Lateral Inspection Findings
Roots
White Copy: Property Owner
°•
Time •
/ . j
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
Poor•PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition - _
c/ 2 , _ 1,. - ✓_: ' - --,1 f � • 2 ,, -t- / . = --- } r
4" to 6 "Transition: Length of Service: i ;`
Yellow Copy: City of Eagan
Record Number
Obstruction No Access
Unable to push past 0 No one in
feet
Entered S L at
am
Time • o pm
Inspector Signature
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH