2082 Jade Lane - Inspection FormsCity of a
Residential Sanitary Sewer Service
•
Compliance Inspection
Date / -
Name 7 7( 4 V)1i_ r
PID Number
House Number
Alternative Mailing Add ss
4" to 6 "Transition:
2o4L
White Copy: Proper ty Owner
Compliance
4O "No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
A-4 As
f • � A am
• Time • +a O pm
Disk #
1 Owner /Occupant Signature
0
Street Name
Service Lateral Inspection Findings
Roots' i -
1 1
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection._____:
Damaged Pipe —_
Transition
Phne
(:inspector Signature
l
For information call 651.470.2788
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:
Record Number
Time
Obstruction
Unable to push past
feet
•
•
Number of stacks ( Entered 5 L.at 3.
Final Cleanout:
Notes
elf
.1
Aam
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
: Discharged
Incorrectly
`
Unknown
Total
Sump pumps
-,'''
w q d
Foundation drains
C
"y-
`'
W' _- ...-- __
__
Roof drains
"
City of a
Residential Sanitary Sewer Service
•
Compliance Inspection
Date / -
Name 7 7( 4 V)1i_ r
PID Number
House Number
Alternative Mailing Add ss
4" to 6 "Transition:
2o4L
White Copy: Proper ty Owner
Compliance
4O "No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
A-4 As
f • � A am
• Time • +a O pm
Disk #
1 Owner /Occupant Signature
0
Street Name
Service Lateral Inspection Findings
Roots' i -
1 1
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection._____:
Damaged Pipe —_
Transition
Phne
(:inspector Signature
l
For information call 651.470.2788
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:
Record Number
Time
Obstruction
Unable to push past
feet
•
•
Number of stacks ( Entered 5 L.at 3.
Final Cleanout:
Notes
elf
.1
Aam
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
City of a
Residential Sanitary Sewer Service
•
Compliance Inspection
Date / -
Name 7 7( 4 V)1i_ r
PID Number
House Number
Alternative Mailing Add ss
4" to 6 "Transition:
2o4L
White Copy: Proper ty Owner
Compliance
4O "No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
A-4 As
f • � A am
• Time • +a O pm
Disk #
1 Owner /Occupant Signature
0
Street Name
Service Lateral Inspection Findings
Roots' i -
1 1
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection._____:
Damaged Pipe —_
Transition
Phne
(:inspector Signature
l
For information call 651.470.2788
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:
Record Number
Time
Obstruction
Unable to push past
feet
•
•
Number of stacks ( Entered 5 L.at 3.
Final Cleanout:
Notes
elf
.1
Aam
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
: Discharged
Incorrectly
`
Unknown
Total
Sump pumps
-,'''
w q d
Foundation drains
C
"y-
`'
W' _- ...-- __
__
Roof drains
"
City of a
Residential Sanitary Sewer Service
•
Compliance Inspection
Date / -
Name 7 7( 4 V)1i_ r
PID Number
House Number
Alternative Mailing Add ss
4" to 6 "Transition:
2o4L
White Copy: Proper ty Owner
Compliance
4O "No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
A-4 As
f • � A am
• Time • +a O pm
Disk #
1 Owner /Occupant Signature
0
Street Name
Service Lateral Inspection Findings
Roots' i -
1 1
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection._____:
Damaged Pipe —_
Transition
Phne
(:inspector Signature
l
For information call 651.470.2788
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:
Record Number
Time
Obstruction
Unable to push past
feet
•
•
Number of stacks ( Entered 5 L.at 3.
Final Cleanout:
Notes
elf
.1
Aam
0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH