2045 Emerald Lane - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date ail /7 f/
• r O am
Time f' / ■ l�
Name ,../(-- i ' - it/t"A — Disk # FF
PID Number
House Number .0 e/--- — Street Name
Alternative Mailing Address Phgje
Roots
Transition
4" to 6 "Transition:
White Copy: Property Owner
OwnerlOccupant Signature
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
Non- Compliance
n• ec c¢ Le q.[p
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
For information call 651.470.2788
Obstruction
inspector Signature
Service Lateral Inspection Findings Number of stacks f Entered S L at
/C /e'er(
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe -
#f' •
J
Final Cleanout:
• O am
• O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes is�; �
'
-; 4 1 ," i i�,t, PEA/ J . }
° ' '�,A. ,
f
//f �!' r - i 4i
6.si ,4 lsay.r �-`o `.r-. //'
'._
Total
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date ail /7 f/
• r O am
Time f' / ■ l�
Name ,../(-- i ' - it/t"A — Disk # FF
PID Number
House Number .0 e/--- — Street Name
Alternative Mailing Address Phgje
Roots
Transition
4" to 6 "Transition:
White Copy: Property Owner
OwnerlOccupant Signature
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
Non- Compliance
n• ec c¢ Le q.[p
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
For information call 651.470.2788
Obstruction
inspector Signature
Service Lateral Inspection Findings Number of stacks f Entered S L at
/C /e'er(
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe -
#f' •
J
Final Cleanout:
• O am
• O pm
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Sump pumps,
,W , ____
.__ ......_.._.
Foundation drains
'�
�_ —
Roof drains
p _
,mss
.._.___._._____..__
City of Cain
Residential Sanitary Sewer Service
Compliance Inspection
Date { c / /
Name
eY d Disk #
HD Number
House Number
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
43 No sump pump
Service Lateral Inspection Findings
Mineral Deposits
Sag /Pipe Deflection
4" to 6 "Transition:
White Copy: Property Owner
/ /7 ( J a /c,_
Total
am
Time ,d7 wp
Street Name
Owner /Occupant Signature
( (
Damaged Pipe
Transition 'V /
Poor Pipe Joints
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
Number of stacks 1
}loots
; iG''�
� r
Length of Service:
Number; Discharged
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Record Number.
DJ
r
• O am
Time r — • •
' d pm
!n §pector Signature
Obstruction
Unable to push past
feet
Notes
Ph¢re
EJ „ 1 2g
For. information 'caII65 470.2788
EnteredSLat /r>Cr
Final Cleandut: J
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH