2134 Jade Pt - Inspection Formi' i ocp
City ai Eaaan
Residential Sanitary Sewer Service
Compliance Inspection
Date ( )5 t c 7 1 /CJ
Name (1
4" to 6" Transition:
White Copy: Property Owner
44 .J)
isk #
PIP Number
House Number 4 inf
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
OwnerlOccufxant Signature
• Oam
Time / s cr pm
Street Name _ -Jr i )6
Service Lateral Inspection Findings Number of stacks
Length of Service:
(F 1 & — m o
Alternative Mailing Address
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
Yellow Copy: City of Eagan
J
I I Time
Record Number
O am
•
• O pm
i��-
Phone (I%9 e2/2 -/z7,2
/
/
..inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
141
Final Cleanout:
No Access
O No one in
'Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes 71 n 6 -IZ
'7A .. . -- ' 6,,,. ' 5, , -� � '�
~
'
i ff # ;�� . /7._
Total
Sump pumps
Foundation drains
---
Roof drains
i' i ocp
City ai Eaaan
Residential Sanitary Sewer Service
Compliance Inspection
Date ( )5 t c 7 1 /CJ
Name (1
4" to 6" Transition:
White Copy: Property Owner
44 .J)
isk #
PIP Number
House Number 4 inf
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
OwnerlOccufxant Signature
• Oam
Time / s cr pm
Street Name _ -Jr i )6
Service Lateral Inspection Findings Number of stacks
Length of Service:
(F 1 & — m o
Alternative Mailing Address
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
Yellow Copy: City of Eagan
J
I I Time
Record Number
O am
•
• O pm
i��-
Phone (I%9 e2/2 -/z7,2
/
/
..inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered S.L.at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
141
Final Cleanout:
No Access
O No one in
'Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
" City of to
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
�V f
Name j\- ;' ) i-°`-'1 2 Disk #
PID Number
Street Name /7(">
House Number
Alternative Mailing Address _
f
/ 11 l
/ ,; { ..
OwnerlQccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
9
No sump pump
Service Lateral Inspectiop Findin
Roots
Poor Pipe Joints
4" to 6" Transition:
White Copy: Property Owner
• �� am
Time I • pm
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
Yellow Copy: City of Eagan
Record Number
ime
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe r 1
I f j /
Transition? u.. ���' l �"
Phone 6 ` L7 /2 7 7
•
inspector Signature
Obstruction
Unable to push past
feet
Length of Service: '� Final Cleanout:
For information call 6S 1:470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
$ Num ter;,ofLstacks — Entere S.L at
!am
m
Pink Copy: SEH
Number Discharged
Unknown
N otes
t ())../c /4 a �, r
r —=c r
r 1 ;
' I/ L... .•
. ,L..--',,/ l - • '
n
i ) 1 gIg
Total
Correctly
Incorrectly
Sump pumps
Foundation drains •
Roof drains
0 4
" City of to
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
�V f
Name j\- ;' ) i-°`-'1 2 Disk #
PID Number
Street Name /7(">
House Number
Alternative Mailing Address _
f
/ 11 l
/ ,; { ..
OwnerlQccupant Signature
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
9
No sump pump
Service Lateral Inspectiop Findin
Roots
Poor Pipe Joints
4" to 6" Transition:
White Copy: Property Owner
• �� am
Time I • pm
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
Yellow Copy: City of Eagan
Record Number
ime
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe r 1
I f j /
Transition? u.. ���' l �"
Phone 6 ` L7 /2 7 7
•
inspector Signature
Obstruction
Unable to push past
feet
Length of Service: '� Final Cleanout:
For information call 6S 1:470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
$ Num ter;,ofLstacks — Entere S.L at
!am
m
Pink Copy: SEH