2042 Jade Lane - Inspection Form1'58
City of EaRa11
Residential Sanitary Sewer Service
Compliance Inspection
Date ca / ( "2- 5-
? ! //2
White Copy: Property Owner
4" to 6" Transition:
7.•
Time • c
Name , >!l'1/ -.PAX r Disk #
f
PID Number
House Number
Alternative Mailing Address
OwnerlOccupant Signature
For information call 65
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
Oam
pm
LL LE
Street Name --- °'""
Non
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number of stacks Entered S L. at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone `5 ✓;� /
.f
inspector Signature
Obstruction
Unable to push past
feet.
Final Cieanout:
O am
•
• O pm
No 4ccess
No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number;
Correctly
Discharged
Incorrectly
Notes ' / f 1 {f ) �/j
,.r f' / /) lc- / / i . i <
Total
Unknown
,/,-2,/...„//..'„,-
/ �+
%+ / ✓ ('') � •_-
I wr ✓
t /
n f
f i !
/I
Sump pumps
Foundation drains
Roof drains
_---4 7, /
1'58
City of EaRa11
Residential Sanitary Sewer Service
Compliance Inspection
Date ca / ( "2- 5-
? ! //2
White Copy: Property Owner
4" to 6" Transition:
7.•
Time • c
Name , >!l'1/ -.PAX r Disk #
f
PID Number
House Number
Alternative Mailing Address
OwnerlOccupant Signature
For information call 65
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
Oam
pm
LL LE
Street Name --- °'""
Non
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
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number of stacks Entered S L. at
Length of Service:
Yellow Copy: City of Eagan
Record Number
Time
Phone `5 ✓;� /
.f
inspector Signature
Obstruction
Unable to push past
feet.
Final Cieanout:
O am
•
• O pm
No 4ccess
No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
. my of F,alao
Residential Sanitary Sewer Service
Compliance Inspection
\ D Number
9 House Number
Date
a
Alternative Mailing Address
For information call 651.470.2788
Compliance
/No foundation drain connection
/Q
No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots / 7 - `
Poor Pipe joints
Mineral Deposits
,`7
Sag /Pipe Deflection
Damaged Pipe
Transition • - /(11
4" to 6" Transition:
White Copy: Property Owner
*` am
Time • b pm
c
Disk #
r?
r i i Street Name
()
Owner /Occupont Signature
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
Number of stacks Entered S L at
r3
//
Length of Service:
Yellow Copy: City of Eagan
Record Number
Li—
Time
4/
Inspector Signature
Obstruction
Unable to push past
feet
•
O
y am
O pm
7
Phone `
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: . !
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
i- f .. , 1. ,
- .,. -z1 s `), ;
Vii✓ 'i) ,` ! i ' ,
_
'/ m ��. ��� i t
Total
Sump pumps
�
Foundation drains
Roof drains
_
. my of F,alao
Residential Sanitary Sewer Service
Compliance Inspection
\ D Number
9 House Number
Date
a
Alternative Mailing Address
For information call 651.470.2788
Compliance
/No foundation drain connection
/Q
No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots / 7 - `
Poor Pipe joints
Mineral Deposits
,`7
Sag /Pipe Deflection
Damaged Pipe
Transition • - /(11
4" to 6" Transition:
White Copy: Property Owner
*` am
Time • b pm
c
Disk #
r?
r i i Street Name
()
Owner /Occupont Signature
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
Number of stacks Entered S L at
r3
//
Length of Service:
Yellow Copy: City of Eagan
Record Number
Li—
Time
4/
Inspector Signature
Obstruction
Unable to push past
feet
•
O
y am
O pm
7
Phone `
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: . !
Pink Copy: SEH