2014 Shale Lane - Inspection FormSump pumps
/
Foundation drains
Roof drains
V\i [
Date(/)
41 11114
ol tapo
• Residential Sanitary Sewer Service
.
Conipliance Inspection
Name
Time
Disk #
MD Number
House Number
4 • )
Alternative Mailing Address
OwnerlOccupant Signature
For information call 651.470„2788
Compliance
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
Service Lateral Inspection Findings
3
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition: (--)
White Copy: Property Owner
411 g am
7 —
/ pm
Street Name
Total Correctly
ED
amo
...:
Non-Compliance
O Cleat 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
W arn
Time. pm
(7 )
Phone
Obstruction
Unable to push past
feet
inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
.,1
Number of stacks Entered SI at
Length of Service:
Number Discharged
incorrectly Unknown
Yellow Copy: City of Eagan
Notes
Final Cleanout:
Pink Copy: SEH