2098 Jade Lane - Inspection FormResidential ;Sanitary Sewer Service
Compliance Inspection
Date ii ; / 1 /
Name f� O
- ` i
PID Number
House Number ! r Street Name
Alternative MailingAddress
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
Ser vice Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
Time 1 •
OwnerlOccupant Signature
F % N e cfteeP - l�.:
am
pm
A -[L]
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:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Notes
Time
•
•
Phone (5-) /,—
inspector Signature
For information call 651.470.2788
Final Cleanout:
O am
O pm
No Access
No one in
O Access to service
lateral needed
O Inspection
r efused
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
Residential ;Sanitary Sewer Service
Compliance Inspection
Date ii ; / 1 /
Name f� O
- ` i
PID Number
House Number ! r Street Name
Alternative MailingAddress
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
Ser vice Lateral Inspection Findings
4" to 6 "Transition:
White Copy: Property Owner
Time 1 •
OwnerlOccupant Signature
F % N e cfteeP - l�.:
am
pm
A -[L]
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:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Notes
Time
•
•
Phone (5-) /,—
inspector Signature
For information call 651.470.2788
Final Cleanout:
O am
O pm
No Access
No one in
O Access to service
lateral needed
O Inspection
r efused
Entered S.L.at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
Sump pumps
7 --)
Foundation drains
Roof drains
j
City of Faun
Residential Sanitary Sewer Service
Compliance Inspection
Date 2 ▪ 1 1
'/ 1/1
Name cw 77 Dis3c #
PID Number _
House Number .Z (,i' "- } Street Name
i
Altpativ MailingAddress
/,'„i r ff i( J / , _
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
/k No sump pump
4" to 6" Transit onn:
White Copy: Property Owner
Compliance
N J
No foundation drain connection
f y No roof drain connection
i
Service Lateral Inspection Findings
Time
OwnerlCccupant Signature
G
Phone /t) �°t
J .. �`L :
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
Roots
Poor Pipe joints
Mineral Deposits
''ca /PiP re Deflection . 2 , -P'
Damaged Pipe ' I
j l r ,✓-� .
Transition - � 1 � (.�,� . I �, "•T a� ,� .:.��'� - �- ��/��- { . -""'i".
am
PM
Number Discharged
Total Correctly Incor'r'ectly Unknown
ength of Service: . !
1
Record Number
7
am
Time • pm
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Inspection
refused
7 2
. ` ?� " ,•
O Access to service
lateral needed
1I Entered S.L. at '�' =IG
Notes
Final Cleanout: j
Yellow Copy: City of Eagan Pink Copy: SEH