2058 Jade Lane - Inspection FormCity of Caen
Residential Sanitary Sewer Service
Compliance inspection
/ • • � °vam
Date{' Time �� O ph,
Name i'/ J"'77/
}
PID Number
— > .
House Number 3 Street Name
Altern Mailing Address
For information. call 651.470.2788
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 Number of stack ) Entered S L.at
/fro C.LS _ SS (2
Roots
Disk #
Oivne'r /Occupor�i Signature
L—Ice -in
1 -CU -[J J
...
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
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
Length of Service:
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet.
Notes
Final Cleanout:
0 am
Time • o pm
Pho a Sri 2
1 inspector Signature
No Access
O No one in
t 'Ci . Access to service
\ lateral needed
O Inspection
refused
r r
Pink Copy: SEH
LJ
Number
Correctly
Discharged
Incorrectly Unknown
Total
Sump pumps
Foundation drains
Roof drains
City of Caen
Residential Sanitary Sewer Service
Compliance inspection
/ • • � °vam
Date{' Time �� O ph,
Name i'/ J"'77/
}
PID Number
— > .
House Number 3 Street Name
Altern Mailing Address
For information. call 651.470.2788
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 Number of stack ) Entered S L.at
/fro C.LS _ SS (2
Roots
Disk #
Oivne'r /Occupor�i Signature
L—Ice -in
1 -CU -[J J
...
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
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to b" Transition:
Length of Service:
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet.
Notes
Final Cleanout:
0 am
Time • o pm
Pho a Sri 2
1 inspector Signature
No Access
O No one in
t 'Ci . Access to service
\ lateral needed
O Inspection
refused
r r
Pink Copy: SEH
LJ
Notes
Number D
Discharged
Total C
Incorrectly U
Unknown
Sump pumps f
f �j`
Foundation drains 7
7 °
°'�" °
°""� " "�`
Roof drains
Date ` "- // /
Name f�
PID Number
House Number
Compliance
4" to 6" Transiti6n:
City nE taaa
Residential Sanitary Sewer Service
Compliance Inspection
`' ./77X . Disk #
Alternative Mailing Address
ow' rierlOccupant Signature
For information call 651.470:2788
No foundation drain connection
- No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
Y'No sump pump
Service Lateral Inspection Findings
Roots -" .L. ' f
Poor Pipe Joints
Mineral Deposits 0 '. .z::7:1---
/C"
f' i
Sag/Pipe Deflection
Damaged Pipe 1
e6.
}
Transition z }� �'
White Copy: Property Owner
/1 • F 'am
Time /- •__50 'p pm
Street Name
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 77, /s
i a "rG_cS)
Length of Service:
L%
Yellow Copy: City of Eagan
Record Number
r
3 Time
Obstruction
Unable to push past
feet
• Fr
' Inspector Signature
am )
Pnl
Phone )
�� - r_
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Final Cleanout:
Pink Copy: SEH