2086 Jade Lane - Inspection FormsSump pumps
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Foundation drains
Roof drains
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41111
City ol taao
Reside
•
.7"
Date L /
Name -
PID Number
House Number
Alternative Mailing Address
9 am
Time • )4) p
Disk #
(e, Street Name
OwnerlOccupantegnature
For information call 651.470.2788
Compliance
O No foundation drain connection
. )!c? No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
1 ): No sump pump
Non-Compliance
0
0
Service Lateral inspection Findings
Roots
Poor PipeJoints
Mineral Deposits
(Q'ipe Deflection 1
Damaged Pipe
4" to 6" Transition:
White Copy: Property Owner
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks Entered S.L.at
, r
Transition
1
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Fagan
Record Number
1 a
Time • o pm
)
Phone
M Th
Inspector Signature
obstruction
Unable to push past
feet
fJ
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Cleanout:
Notels
,,-70
Pink Copy: SEH
Sump pumps
Foundation drains
Roof drains
City of lid o `.
Residential Sanitary Sewer Service
Compliance Inspection
Date L /
Name
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
PID Number
House Number (?',! Street Name
Alternative Mailing Address
, k // /L 1 ) )/ Disk #
t '
Owner /Occupantegnature
White Copy: Property Owner
} ! -KO 9 am
Time �- • p p
Non - Compliance
0
0
0
0
0
te e ' '
Record Number �?
Time • o pm
L
Phone ti " �r'> C-✓ )(
Inspector Signature
For information call 651.470.2788
Service Lateral Inspection Findings
Roots / , /
Poor Pipe Joints
Mineral Deposits 9
(Q'ipe Deflection . ' 7 -` "
Damaged Pipe i
s J
Transition 1 r /r1-72 -..°. /_.
' 6
Number. Discharged
Total Correctly Incorrectly Unknown
obstruction
Unable to push past
feet
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks . Entered S . at��`t
am
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
r)
Length of Service: 7C5).P - Final Cleanout: f J t
Not s
� _s )
� . ci s
Yellow Copy: City of Eagan Pink Copy: SEH