1996 Zircon Lane - Inspection Formsl
g8'
Date/;-:7 ! / )(1)
Name .
Dis #
PID Number
House Number Street Name
Alternative Mailing Address
4" to b "Transition:
White Copy: Propel ty Owner
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
Time
Owner /Occupant Signature
Service Lateral Inspection Findings
-
Residential Sanitary Sewer Service
Compliance Inspection
,p am
;, pm
1-L1
For information call 651.470.2788
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
Length of Service:
Record Number
Time
Phone
Obstruction
Unable to push past
feet
Entered S L at
Inspector Signature
• O am,
• O Pm
No Access
O No one in
1
� 0 Access to service
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
I ote
/ C
Final Cleanout:
! t I
•
Yellow Copy: City of Eagan Pink Copy: SEH
Total C
'Number D
Discharged
Correctly I
Incorrectly U
Unknown
Sump pumps
Foundation drains
Roof drains
g8'
Date/;-:7 ! / )(1)
Name .
Dis #
PID Number
House Number Street Name
Alternative Mailing Address
4" to b "Transition:
White Copy: Propel ty Owner
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
Time
Owner /Occupant Signature
Service Lateral Inspection Findings
-
Residential Sanitary Sewer Service
Compliance Inspection
,p am
;, pm
1-L1
For information call 651.470.2788
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
Length of Service:
Record Number
Time
Phone
Obstruction
Unable to push past
feet
Entered S L at
Inspector Signature
• O am,
• O Pm
No Access
O No one in
1
� 0 Access to service
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
I ote
/ C
Final Cleanout:
! t I
•
Yellow Copy: City of Eagan Pink Copy: SEH
Sump pumps
Foundation drains
Roof drains
' f '
Residential Sanitary Sewer Ser vic
Cohnpliance Inspection
�I s� S iret-fchid
Date i,
Name
Com
l,)\ O r Q
O
I
Poor Pipe joints
Mineral Deposits
4" to 6 "Transition:
•
Time :e : $
1/1/ Disk 34
PID Number
House Number I_ ,1 `- .i( Street Name
Alternative Mailing Address
Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
White Copy: Property Owner
Owner /Occupant Signature
� fiance
No foundation drain connection
No roof drain connection
Service Lateral Inspection Findin s�
Roots 7/
Sag /Pipe Deflection
Damaged Pipe
Transition L 7 i / (2( i ?`>
c am
0 pm
Length of Service:
Total Correctly Incorrectly Unknown
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
Number Discharged
Record Number
l j •
may
Time e
/ r
Phone
Entered S L at
Notes
rl
Inspector
For informatran.calll 651:470.27'88
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
am
Pm
�f F inal Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH