4109 Diamond Dr - Inspection FormsCity of lapao
Residential Sanitary Sewer Service
Compliance Inspection
Date / / ( i'
Name
PID Number
House Number
Alternative MailingAddress
4" to 6 "Transition:
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
Transition
White Copy: Property Owner
Time
Disk #
Street Name
Owner /Occupant Signature
CO p, am
Pm
Service Lateral Ins ection Findigs
Roots / . ,
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
mber of stacks
Length of Service:
Yellow Copy: City of Eagan
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
Record Number
0 a
Time
Phone r - 7 r i � ( j - 44-)-
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
S L at <� /�, i'
Final Cleanout:
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
pm
Pink Copy: SEH
Number
Correctly
Discharged
Note s
1 ! °'
�/ '� 1A i ("7 � 7e3t
fq f � t ._ s
,
Total
Incorrectly
Unknown
Sump pumps
l -
Foundation drains
e/
Roof drains
.'
City of lapao
Residential Sanitary Sewer Service
Compliance Inspection
Date / / ( i'
Name
PID Number
House Number
Alternative MailingAddress
4" to 6 "Transition:
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
Transition
White Copy: Property Owner
Time
Disk #
Street Name
Owner /Occupant Signature
CO p, am
Pm
Service Lateral Ins ection Findigs
Roots / . ,
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
mber of stacks
Length of Service:
Yellow Copy: City of Eagan
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
Record Number
0 a
Time
Phone r - 7 r i � ( j - 44-)-
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
S L at <� /�, i'
Final Cleanout:
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
pm
Pink Copy: SEH
City of lapao
Residential Sanitary Sewer Service
Compliance Inspection
Date / / ( i'
Name
PID Number
House Number
Alternative MailingAddress
4" to 6 "Transition:
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
Transition
White Copy: Property Owner
Time
Disk #
Street Name
Owner /Occupant Signature
CO p, am
Pm
Service Lateral Ins ection Findigs
Roots / . ,
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
mber of stacks
Length of Service:
Yellow Copy: City of Eagan
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
Record Number
0 a
Time
Phone r - 7 r i � ( j - 44-)-
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
S L at <� /�, i'
Final Cleanout:
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
pm
Pink Copy: SEH
Number
Correctly
Discharged
Note s
1 ! °'
�/ '� 1A i ("7 � 7e3t
fq f � t ._ s
,
Total
Incorrectly
Unknown
Sump pumps
l -
Foundation drains
e/
Roof drains
.'
City of lapao
Residential Sanitary Sewer Service
Compliance Inspection
Date / / ( i'
Name
PID Number
House Number
Alternative MailingAddress
4" to 6 "Transition:
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
Transition
White Copy: Property Owner
Time
Disk #
Street Name
Owner /Occupant Signature
CO p, am
Pm
Service Lateral Ins ection Findigs
Roots / . ,
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
mber of stacks
Length of Service:
Yellow Copy: City of Eagan
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
Record Number
0 a
Time
Phone r - 7 r i � ( j - 44-)-
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
S L at <� /�, i'
Final Cleanout:
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
pm
Pink Copy: SEH