2057 Bluestone Lane - Inspection Forms18'1-3`
Residential Sanitary Sewer Service .
Compliance Inspection
Z )
Name
Alternative Mailing Address
4L ) C,
4" to 6 "Transition:
White Copy: Property Owner
1 11 - - A
Time •) • pm
sk #
PID Number
r Y
House Number_ f S treet Name
Owner/Occupant 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
r , Z� - ic� . -c�C�
-W-
For information call 65
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
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots r
Poor Pipe Joints �° r j f J /
1
... f
Mineral Deposits {' =���✓ ] � � - L- -� .___. `- �' /%
Sag /Pipe Deflection • P.--/".-2. I : : / - � '�i i- :)
Length of Service:
Yellow Copy: City of Eagan
Record Number f
Obstruction
Unable to push past
feet
Notes
Time
•
•
Phone
�C ✓ ( * `]' f
inspector Signature
Final Cleanout:
o am
o pm
No Access
0. No one in
f F Access to service
la ) rrs
0 Insp
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
18'1-3`
Residential Sanitary Sewer Service .
Compliance Inspection
Z )
Name
Alternative Mailing Address
4L ) C,
4" to 6 "Transition:
White Copy: Property Owner
1 11 - - A
Time •) • pm
sk #
PID Number
r Y
House Number_ f S treet Name
Owner/Occupant 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
r , Z� - ic� . -c�C�
-W-
For information call 65
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
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots r
Poor Pipe Joints �° r j f J /
1
... f
Mineral Deposits {' =���✓ ] � � - L- -� .___. `- �' /%
Sag /Pipe Deflection • P.--/".-2. I : : / - � '�i i- :)
Length of Service:
Yellow Copy: City of Eagan
Record Number f
Obstruction
Unable to push past
feet
Notes
Time
•
•
Phone
�C ✓ ( * `]' f
inspector Signature
Final Cleanout:
o am
o pm
No Access
0. No one in
f F Access to service
la ) rrs
0 Insp
refused
Pink Copy: SEH
Sump pumps
I
Foundation drains
.7)
drains
0 Roof
LJ
City a Ea a
Residential Sanitary Sewer Service
Compliance Inspection
. 2 • C ✓ Q am
Date t2 / /C7 / 1. i Time . •
pm
Name
PID Number
House Number .:' J / Street Name
Alternative Mailing Address
0
rl
0
T il t`. -- D isk #
Owner /Occupant Signature
pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
No sump pump
Service Lateral I npection Findings
Roots
-
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
rs a
4
/
Transition )
"
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
Length of Service: r,
Number. Discharged
Total Correctly Incorrectly Unknown
Record Number
Notes
Time
Phone .. O C ✓ I
Obstruction
Inspector Signature
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
i
✓ ;
m
For information call 65
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S.L.at
Final Cleanout: (% ,h:.7
Yellow Copy: City of Eagan Pink Copy: SEH
18'1-3`
Residential Sanitary Sewer Service .
Compliance Inspection
Z )
Name
Alternative Mailing Address
4L ) C,
4" to 6 "Transition:
White Copy: Property Owner
1 11 - - A
Time •) • pm
sk #
PID Number
r Y
House Number_ f S treet Name
Owner/Occupant 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
r , Z� - ic� . -c�C�
-W-
For information call 65
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
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots r
Poor Pipe Joints �° r j f J /
1
... f
Mineral Deposits {' =���✓ ] � � - L- -� .___. `- �' /%
Sag /Pipe Deflection • P.--/".-2. I : : / - � '�i i- :)
Length of Service:
Yellow Copy: City of Eagan
Record Number f
Obstruction
Unable to push past
feet
Notes
Time
•
•
Phone
�C ✓ ( * `]' f
inspector Signature
Final Cleanout:
o am
o pm
No Access
0. No one in
f F Access to service
la ) rrs
0 Insp
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
18'1-3`
Residential Sanitary Sewer Service .
Compliance Inspection
Z )
Name
Alternative Mailing Address
4L ) C,
4" to 6 "Transition:
White Copy: Property Owner
1 11 - - A
Time •) • pm
sk #
PID Number
r Y
House Number_ f S treet Name
Owner/Occupant 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
r , Z� - ic� . -c�C�
-W-
For information call 65
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
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots r
Poor Pipe Joints �° r j f J /
1
... f
Mineral Deposits {' =���✓ ] � � - L- -� .___. `- �' /%
Sag /Pipe Deflection • P.--/".-2. I : : / - � '�i i- :)
Length of Service:
Yellow Copy: City of Eagan
Record Number f
Obstruction
Unable to push past
feet
Notes
Time
•
•
Phone
�C ✓ ( * `]' f
inspector Signature
Final Cleanout:
o am
o pm
No Access
0. No one in
f F Access to service
la ) rrs
0 Insp
refused
Pink Copy: SEH