4134 Topaz Dr - Inspection FormsResidential 'Sanitary Sealer Service
Compliance, Inspection
Date `? /
fl � '
T: V
)� }� i / Q am
L
Time 1.. O pm
Name / A :b )J'? 42h/"/ lA Disk #
PID Number 1 ` )
House Number t J __ -1 -- Street Name
Alternative Mailing Address
Owner /Occupant Signature
o pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
g No sump pump
Service La teral Inspection Findings
M Cr r' t P.'7v
'r
Roots ,�, � /' J 1: /C �
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
N� rr)b eof sta ks
Length of Service:
J f7 071Z
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
am
Time li • O Pm
Phone (= - 7 ! r . 2
Inspector Signature
For information
call 651.470 2788
Obstruction
Unable to push past
feet
Entered S.L. at-'1 r12C?
- Final Cleanout:
Notes
_gC
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Number.
Cor rectly
Discharged
Incorrectly
`.
Unknown
Sump pumps
Foundation drains
r
Roof drains
()
Residential 'Sanitary Sealer Service
Compliance, Inspection
Date `? /
fl � '
T: V
)� }� i / Q am
L
Time 1.. O pm
Name / A :b )J'? 42h/"/ lA Disk #
PID Number 1 ` )
House Number t J __ -1 -- Street Name
Alternative Mailing Address
Owner /Occupant Signature
o pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
g No sump pump
Service La teral Inspection Findings
M Cr r' t P.'7v
'r
Roots ,�, � /' J 1: /C �
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
N� rr)b eof sta ks
Length of Service:
J f7 071Z
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
am
Time li • O Pm
Phone (= - 7 ! r . 2
Inspector Signature
For information
call 651.470 2788
Obstruction
Unable to push past
feet
Entered S.L. at-'1 r12C?
- Final Cleanout:
Notes
_gC
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Residential 'Sanitary Sealer Service
Compliance, Inspection
Date `? /
fl � '
o pliance
No foundation drain connection
No roof drain connection
D Sump pit not connected to
sanitary sewer
O Sump pump properly piped
g No sump pump
Sag /Pipe Deflection_
Damaged Pipe
Transition , / := ?f
4" to 6" Transition:
White Copy: Property Owner
T: V
)� }� i / Q am
Time ! '•. O pm
Name / A :b )J'? h/"/ lA Disk #
PID Number 1 ` )
House Number t J __ -1 -- Street Name
Alternative Mailing Address
Owner /Occupant Signature
Service La teral Inspection Findings
M Cr r' t P.'7v
'r
Roots ,�, � /' J 1: /C �
Poor Pipe joints
Mineral Deposits
J f7 071Z
For information
call 651.470 2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
U Sump pump connected to sanitary
sewer
Q Flexible sump pump piping
N� rr)b eof sta ks
Length of Service:
Yellow Copy: City of Eagan
Record Number
am
Time li • O Pm
Phone (= - 7 ! r . 2
Inspector Signature
Obstruction
Unable to push past
feet
Entered St. a r c- ?k
Notes
_gC
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f � — . ,I - Final Cleanout:
Pink Copy: SEH
Total
Number.
Cor rectly
Discharged
Incorrectly
`.
Unknown
Sump pumps
Foundation drains
r
Roof drains
()
Residential 'Sanitary Sealer Service
Compliance, Inspection
Date `? /
fl � '
o pliance
No foundation drain connection
No roof drain connection
D Sump pit not connected to
sanitary sewer
O Sump pump properly piped
g No sump pump
Sag /Pipe Deflection_
Damaged Pipe
Transition , / := ?f
4" to 6" Transition:
White Copy: Property Owner
T: V
)� }� i / Q am
Time ! '•. O pm
Name / A :b )J'? h/"/ lA Disk #
PID Number 1 ` )
House Number t J __ -1 -- Street Name
Alternative Mailing Address
Owner /Occupant Signature
Service La teral Inspection Findings
M Cr r' t P.'7v
'r
Roots ,�, � /' J 1: /C �
Poor Pipe joints
Mineral Deposits
J f7 071Z
For information
call 651.470 2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
U Sump pump connected to sanitary
sewer
Q Flexible sump pump piping
N� rr)b eof sta ks
Length of Service:
Yellow Copy: City of Eagan
Record Number
am
Time li • O Pm
Phone (= - 7 ! r . 2
Inspector Signature
Obstruction
Unable to push past
feet
Entered St. a r c- ?k
Notes
_gC
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f � — . ,I - Final Cleanout:
Pink Copy: SEH