2091 Opal Dr - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date I 1 )(1
Name J ° ✓isk
'D
PID Number.
House Number. // ? -J / Street Name
Alternative Mailing Address
OwnerlQccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
• . 4 . am
Time ( ) • 1 0 pm
-DJ -[1 J
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
Time
�Jl "lam
)_Jf
Phone /
Inspector Signature
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
o am
•
• o lam
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Notes
� � ` 1 i
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date I 1 )(1
Name J ° ✓isk
'D
PID Number.
House Number. // ? -J / Street Name
Alternative Mailing Address
OwnerlQccupant Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral inspection Findings Number of stacks Entered S. L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Property Owner
• . 4 . am
Time ( ) • 1 0 pm
-DJ -[1 J
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
Time
�Jl "lam
)_Jf
Phone /
Inspector Signature
Obstruction
Unable to push past
feet
Length of Service: Final Cleanout:
o am
•
• o lam
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Notes
� � ` 1 i
Pink Copy: SEH
Sump pumps
/
t
Foundation drains
Roof drains
r t
z ` MY of 1a as
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 / 1 ( 1
�i
Name
PID Number
House Number
Alternative Mailing Address
For information: call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
f
Service Lateral Inspection Findings Number of stacks
Roots / C ,tr --
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection .
Damaged Pipe
Transition t / ; 27'2 -
4" to 6" Transition:
White Copy: Property Owner
Owner/Occupant Signature
Time , > •
Disk #
am
Pm
Street Name � 0(.
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:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Notes
Time d`'
•
Inspector Signature
Obstruction
Unable to push past
feet
Entered S•L• atk-7 ,1f
(
�0 A: )5 77 ]
am
6 pm
Phone r / ^f
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
T
Final Cleanout: / j' 5'
€O
Pink Copy: SFH