2144 Jade Pt - Inspection Forms1 of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 6 ' / / /'a
Name . ./.49 f!r - C - :,) Disk ##
PID Number
Alternative Mailing Address
Compliance
'IGo foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor PipeJoints
■
OwnerlOccupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time U Y__ p pm
House Number I Street Name __
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
Length of Service:
7
Record Numbers
[I] • it'r%rn
Time /c' • 2 o pm
Pho1pe °f-�`
` 7 .-''' inspector Signature
(/
For information ` call 65 1.47
•
Service Lateral Inspection Findings Number of stacks / Entered St at
c a
Roots-37 / fir ', 7 • '
Obstruction
Unable to push past
feet
Notes ,, �.
� �, •� ..
Final Cleanout:
r •
•
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
/91
Yellow Copy: City of Eagan Pink Copy: SEH
Number Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
_
_ __
---- _.
Foundation drains
, f'�'`i
Roof drains
1 of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 6 ' / / /'a
Name . ./.49 f!r - C - :,) Disk ##
PID Number
Alternative Mailing Address
Compliance
'IGo foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor PipeJoints
■
OwnerlOccupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time U Y__ p pm
House Number I Street Name __
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
Length of Service:
7
Record Numbers
[I] • it'r%rn
Time /c' • 2 o pm
Pho1pe °f-�`
` 7 .-''' inspector Signature
(/
For information ` call 65 1.47
•
Service Lateral Inspection Findings Number of stacks / Entered St at
c a
Roots-37 / fir ', 7 • '
Obstruction
Unable to push past
feet
Notes ,, �.
� �, •� ..
Final Cleanout:
r •
•
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
/91
Yellow Copy: City of Eagan Pink Copy: SEH
1 of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 6 ' / / /'a
Name . ./.49 f!r - C - :,) Disk ##
PID Number
Alternative Mailing Address
Compliance
'IGo foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor PipeJoints
■
OwnerlOccupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time U Y__ p pm
House Number I Street Name __
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
Length of Service:
7
Record Numbers
[I] • it'r%rn
Time /c' • 2 o pm
Pho1pe °f-�`
` 7 .-''' inspector Signature
(/
For information ` call 65 1.47
•
Service Lateral Inspection Findings Number of stacks / Entered St at
c a
Roots-37 / fir ', 7 • '
Obstruction
Unable to push past
feet
Notes ,, �.
� �, •� ..
Final Cleanout:
r •
•
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
/91
Yellow Copy: City of Eagan Pink Copy: SEH
Number Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
_
_ __
---- _.
Foundation drains
, f'�'`i
Roof drains
1 of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date 0 6 ' / / /'a
Name . ./.49 f!r - C - :,) Disk ##
PID Number
Alternative Mailing Address
Compliance
'IGo foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor PipeJoints
■
OwnerlOccupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time U Y__ p pm
House Number I Street Name __
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
Length of Service:
7
Record Numbers
[I] • it'r%rn
Time /c' • 2 o pm
Pho1pe °f-�`
` 7 .-''' inspector Signature
(/
For information ` call 65 1.47
•
Service Lateral Inspection Findings Number of stacks / Entered St at
c a
Roots-37 / fir ', 7 • '
Obstruction
Unable to push past
feet
Notes ,, �.
� �, •� ..
Final Cleanout:
r •
•
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
/91
Yellow Copy: City of Eagan Pink Copy: SEH