1485 Thomas Lane - Inspection FormResidential Sanitary Sewer Service
City of liaiao Compliance Inspection
Date 1 1r i
Name ) ? , � f Disk #
PO Number
House Number Street Name
Alternative Mailing Address
t 1
` Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to b" Transition:
White Copy: Property Owner
Time
_am
pm
Yellow Copy: City of Eagan
/ .r
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
Length of Service: ) l
Record Number
am
Time - + ® _ pm
Phone /,`, L T
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Final Cleanout:
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe ! l
Transition 1: r :� (04. y`J 7
�7 1
Pink Copy: SEH
Total
Notes
' n 1
' " ' _ �
ii . eil � 1 1 G .
ff)
-9 ,
�'
Number
. Dischaged
e,
Correctly
Incorrectly
Unknown
Sump pumps
;041_577")
'1
-
f 4- () T 'f
i %lam
Foundation drains
Roof drains
Residential Sanitary Sewer Service
City of liaiao Compliance Inspection
Date 1 1r i
Name ) ? , � f Disk #
PO Number
House Number Street Name
Alternative Mailing Address
t 1
` Owner /Occupant Signature
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to b" Transition:
White Copy: Property Owner
Time
_am
pm
Yellow Copy: City of Eagan
/ .r
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
Length of Service: ) l
Record Number
am
Time - + ® _ pm
Phone /,`, L T
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet.
Final Cleanout:
r
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe ! l
Transition 1: r :� (04. y`J 7
�7 1
Pink Copy: SEH