2070 Jade Lane - Inspection FormsResiden Sanitary Sewer Service
Compliance Inspection
Date O 1 ( 1 /c
l '.. / C Disk #
Name /��:�r�'
PID Number'
House Number
Alternative Mailing Address
/
Compliance
O No foundation drain connection
6 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
> Y
/at �° Z 42 1 ;i` i
OwnerlOccupant Sigrt'ature
No sump pump
Street Name
Service Lateral Inspection Findings
Roots / > +fir
Poor Pipe joints _.
Mineral Deposits J1.� :N
�� am
Time d : o pm
Sag /Pipe Deflection
Damaged Pipe
Transition ''''X'
4" to 6" Transition:
White Copy: Property Owner
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
,
Phone,( 7°2
' 4/
f Inspector Signature
•
or information call 651 470.27 88
Number of stacks Entered S. L.at
Length of Service:
Obstruction
Unable to push past
feet
Time
-6-am
/ Opm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
'
Final Cleanout: (W .r`.
Notes o o �'
C. 4.4
,-V,E -V -v (b/t.,-,,87?
Pink Copy: SEH
Total
':.Number
Discharged
Correctly
incorrectly
Unknown
Sump pumlis
. -�-.� A�
_ ,,
"-°-
Foundation drains
Roof drains
Residen Sanitary Sewer Service
Compliance Inspection
Date O 1 ( 1 /c
l '.. / C Disk #
Name /��:�r�'
PID Number'
House Number
Alternative Mailing Address
/
Compliance
O No foundation drain connection
6 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
> Y
/at �° Z 42 1 ;i` i
OwnerlOccupant Sigrt'ature
No sump pump
Street Name
Service Lateral Inspection Findings
Roots / > +fir
Poor Pipe joints _.
Mineral Deposits J1.� :N
�� am
Time d : o pm
Sag /Pipe Deflection
Damaged Pipe
Transition ''''X'
4" to 6" Transition:
White Copy: Property Owner
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
,
Phone,( 7°2
' 4/
f Inspector Signature
•
or information call 651 470.27 88
Number of stacks Entered S. L.at
Length of Service:
Obstruction
Unable to push past
feet
Time
-6-am
/ Opm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
'
Final Cleanout: (W .r`.
Notes o o �'
C. 4.4
,-V,E -V -v (b/t.,-,,87?
Pink Copy: SEH
Residen Sanitary Sewer Service
Compliance Inspection
Date O 1 ( 1 /c
l '.. / C Disk #
Name /��:�r�'
PID Number'
House Number
Alternative Mailing Address
/
Compliance
O No foundation drain connection
6 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
> Y
/at �° Z 42 1 ;i` i
OwnerlOccupant Sigrt'ature
No sump pump
Street Name
Service Lateral Inspection Findings
Roots / > +fir
Poor Pipe joints _.
Mineral Deposits J1.� :N
�� am
Time d : o pm
Sag /Pipe Deflection
Damaged Pipe
Transition ''''X'
4" to 6" Transition:
White Copy: Property Owner
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
,
Phone,( 7°2
' 4/
f Inspector Signature
•
or information call 651 470.27 88
Number of stacks Entered S. L.at
Length of Service:
Obstruction
Unable to push past
feet
Time
-6-am
/ Opm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
'
Final Cleanout: (W .r`.
Notes o o �'
C. 4.4
,-V,E -V -v (b/t.,-,,87?
Pink Copy: SEH
Total
':.Number
Discharged
Correctly
incorrectly
Unknown
Sump pumlis
. -�-.� A�
_ ,,
"-°-
Foundation drains
Roof drains
Residen Sanitary Sewer Service
Compliance Inspection
Date O 1 ( 1 /c
l '.. / C Disk #
Name /��:�r�'
PID Number'
House Number
Alternative Mailing Address
/
Compliance
O No foundation drain connection
6 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
> Y
/at �° Z 42 1 ;i` i
OwnerlOccupant Sigrt'ature
No sump pump
Street Name
Service Lateral Inspection Findings
Roots / > +fir
Poor Pipe joints _.
Mineral Deposits J1.� :N
�� am
Time d : o pm
Sag /Pipe Deflection
Damaged Pipe
Transition ''''X'
4" to 6" Transition:
White Copy: Property Owner
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
,
Phone,( 7°2
' 4/
f Inspector Signature
•
or information call 651 470.27 88
Number of stacks Entered S. L.at
Length of Service:
Obstruction
Unable to push past
feet
Time
-6-am
/ Opm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
'
Final Cleanout: (W .r`.
Notes o o �'
C. 4.4
,-V,E -V -v (b/t.,-,,87?
Pink Copy: SEH