2061 Marble Lane - Inspection FormSump pumps
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Foundation drains
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1
Roof drains
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City Eaa ftal
Residential Sanitary Sewer Service
Compliance Inspection
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Date I
r P
y
Jam_
Name .�fi t 'disk #
PID Number
House Number I Street Name
Alternative Mailing Address
Owner /Occupant Signature
For information call 65
Coliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Su_ mp pump properly piped
t
No sump pump
Ser vice Lateral Inspection Findings,
Roots �'.
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Total
Time I-1-_a
am
pm
/ E')
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
3
Obstruction
Unable to push past
feet
rl
Number ?f st c�ks f Entered S L at
Poor Pipe Joints
Mineral Deposits
Length of Service:
Number Discharged
Correctly Incorrectly Unknown
Notes
'i n, am
®atrr
Ifs pm
Time
v r2
Phone
inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH