2042 Bluestone Lane - Inspection FormsCity of iB
Residential; Sanitary Sewer Service
Compliance Inspection
Poor Pipe Joints
Mineral Deposits
r Sag/Pipe Deflection
Damaged Pipe
4" to 6"Transition:
Date ( /
) f
Name t/
7 %a14 Disk #
L
f
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
F O No sump pump
Service L Inspe Findings
Roots :
White Copy: Pr operty Owner
7•
am
Time , ( - • O pm
PID Number
House Number ,.t ,/ 1 Street Name
Alternative Mailing Address
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
y _r
Transition
Length of Service:
Record Number
Number of stacks Entered S L at
Time
inspector Signature
Phone r.!:' �._�
- L 7
Obstruction
Unable to push past
feet.
/- Final Cleanout:
g 3
For inforrnation call 65
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Note's, f �,
Yellow Copy: City of Eagan Pink Copy: SEH
Nur
Correctly
ber:Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of iB
Residential; Sanitary Sewer Service
Compliance Inspection
Poor Pipe Joints
Mineral Deposits
r Sag/Pipe Deflection
Damaged Pipe
4" to 6"Transition:
Date ( /
) f
Name t/
7 %a14 Disk #
L
f
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
F O No sump pump
Service L Inspe Findings
Roots :
White Copy: Pr operty Owner
7•
am
Time , ( - • O pm
PID Number
House Number ,.t ,/ 1 Street Name
Alternative Mailing Address
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
y _r
Transition
Length of Service:
Record Number
Number of stacks Entered S L at
Time
inspector Signature
Phone r.!:' �._�
- L 7
Obstruction
Unable to push past
feet.
/- Final Cleanout:
g 3
For inforrnation call 65
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Note's, f �,
Yellow Copy: City of Eagan Pink Copy: SEH
City of iB
Residential; Sanitary Sewer Service
Compliance Inspection
Date (9 /
/ - __
) f
Name �I j t/
PID Number
House Number ,.t ,/ 1 Street Name
Alternative Mailing Addr ess
Poor PipeJoints
Mineral Deposits
r Sag/Pipe Deflection
Damaged Pipe
4" to 6"Transition:
White Copy: Property Owner
7 %a14 Disk #
L
f
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
F O No sump pump
Service L Inspe Findings
Roots :
,
•
Time /: ' •
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
y _r
am
0 pra
Transition
Length of Service:
Record Number
Number of stacks Entered S L at
Time
Phone r.!:' �._�
- L 7
inspector Signature
For inforrnation call 65
Obstruction
Unable to push past
feet.
/-: Final Cleanout:
Note's.. f �,
(> )/ <,' . :)Z t ` f
g 3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
!J ll r
r, - �a,s •
Yellow Copy: City of Eagan Pink Copy: SEH
Nur
Correctly
ber:Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of iB
Residential; Sanitary Sewer Service
Compliance Inspection
Date (9 /
/ - __
) f
Name �I j t/
PID Number
House Number ,.t ,/ 1 Street Name
Alternative Mailing Addr ess
Poor PipeJoints
Mineral Deposits
r Sag/Pipe Deflection
Damaged Pipe
4" to 6"Transition:
White Copy: Property Owner
7 %a14 Disk #
L
f
Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
F O No sump pump
Service L Inspe Findings
Roots :
,
•
Time /: ' •
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
y _r
am
0 pra
Transition
Length of Service:
Record Number
Number of stacks Entered S L at
Time
Phone r.!:' �._�
- L 7
inspector Signature
For inforrnation call 65
Obstruction
Unable to push past
feet.
/-: Final Cleanout:
Note's.. f �,
(> )/ <,' . :)Z t ` f
g 3
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
!J ll r
r, - �a,s •
Yellow Copy: City of Eagan Pink Copy: SEH