4815 Eriks Blvd - Inspection FormsResidential Sanitary Sewer Service
Compliance Inspection
Date (')
Name OR , / 1 / ' ? Disk #
-07) , 1
PO Number
X-.
House Number Street Name
Alternative Mailing Address
Owner/Occupant Signature
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
4" to 6"Transition:
White Copy: Properypwner
Time Z •
i'tq am
0 pm
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
".7
Record Number
Notes
Time
Phone
Obstruction
Unable to push past
feet
0 am
•
• 0 Pm
Final Cleanout:
2 (1
Inspector Signature
For information call 651.470.2788
No Access
O No one in
A i Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
"
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date (')
Name OR , / 1 / ' ? Disk #
-07) , 1
PO Number
X-.
House Number Street Name
Alternative Mailing Address
Owner/Occupant Signature
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
4" to 6"Transition:
White Copy: Properypwner
Time Z •
i'tq am
0 pm
Non-Compliance
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
".7
Record Number
Notes
Time
Phone
Obstruction
Unable to push past
feet
0 am
•
• 0 Pm
Final Cleanout:
2 (1
Inspector Signature
For information call 651.470.2788
No Access
O No one in
A i Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
"
Pink Copy: SEH
City of Eatao
Residential Sanitary Sewer Service
Compliance Inspection
Date 9 1 ' 1 > ,
Name
i`
PID Number
Time
j 3 I 1 Disk #
i
House Number Street Name
Alternative Mailing Address
aOwner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
; 6 No sump pump
Service Lateral Inspection Findings
Transition
4" to 6" Transition:
White Copy: Property Owner
r
• am
/ pm
1
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
r' .r
l
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Length of Service: '.. = ?_ Final Cleanout:
Yellow Copy: City of Eagan
Record Number
• 77 )
Time / • — o pm
i
: 1
Y
Phone f 1 -
Obstruction
Unable to push past
feet
Inspector Signature
Entered S.L.at
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r di
/1
Pink Copy: SEH
Number Discharged
Correctly Incorrectly Unknown
M--
Notes
Total
Sump pumps
Foundation drains
---
Roof drains'
111
MI
City of Eatao
Residential Sanitary Sewer Service
Compliance Inspection
Date 9 1 ' 1 > ,
Name
i`
PID Number
Time
j 3 I 1 Disk #
i
House Number Street Name
Alternative Mailing Address
aOwner /Occupant Signature
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
; 6 No sump pump
Service Lateral Inspection Findings
Transition
4" to 6" Transition:
White Copy: Property Owner
r
• am
/ pm
1
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
r' .r
l
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Length of Service: '.. = ?_ Final Cleanout:
Yellow Copy: City of Eagan
Record Number
• 77 )
Time / • — o pm
i
: 1
Y
Phone f 1 -
Obstruction
Unable to push past
feet
Inspector Signature
Entered S.L.at
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r di
/1
Pink Copy: SEH