2076 Opal Dr - Inspection FormsCity of lia ri
Residential Sanitary Sewer Service
Compliance Inspection
Date 2/1 T2 1 fa
Name ---- ,c1 ?/
P1D Number
House Number
4" to 6" Transition:
226
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
White Copy: Propel ty Owner
1 /1 °' _a 7- (6
•
o am
Time • o pm
OwnerlOccupant Signature
Disk #
Street Name 4 21
Hi
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:
Record Number.
Time
• O am
O -- o pm
Phone'
////7 :
i I -.6nspectar Signature
For information call 651 470.2788
Obstruction
Unable to push past
feet.
No Access
O No one in
T
Access to service
lateral needed
Final Cleanout:
O Inspection
r efused
Entered S.L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan 1-,� ,e E ,
Pink Copy: SEH
Total
Notes
Xr� �
! f 41,
1
� /
( N IfM
/t"
°-- f k• / ', ,i- r" _- L
-
! - i. ✓'i
i t,
.7+ -� N.:_. t-.� j ; ./ y. ()ft-, ' 1,:f,-177-1:7,-1,/-----
- { %v ft—
r , . i
s.
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City of lia ri
Residential Sanitary Sewer Service
Compliance Inspection
Date 2/1 T2 1 fa
Name ---- ,c1 ?/
P1D Number
House Number
4" to 6" Transition:
226
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
White Copy: Propel ty Owner
1 /1 °' _a 7- (6
•
o am
Time • o pm
OwnerlOccupant Signature
Disk #
Street Name 4 21
Hi
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:
Record Number.
Time
• O am
O -- o pm
Phone'
////7 :
i I -.6nspectar Signature
For information call 651 470.2788
Obstruction
Unable to push past
feet.
No Access
O No one in
T
Access to service
lateral needed
Final Cleanout:
O Inspection
r efused
Entered S.L at
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Yellow Copy: City of Eagan 1-,� ,e E ,
Pink Copy: SEH
City oi Fla p
Residential :Sanitary Sewer Service
Compliance Inspection
Date . f /
f
Name / 7
l�
4" to 6 " Transition:
Alternative Mailing Address
Compliance
O No foundation drain connection
O Sump p it not connected to
sanitary sewer
Sump pump properly piped
No sump pump
No roof drain connection
Service Lateral Inspection Findings
Roots
White Copy: Property Owner
Time
Disk#
Owner /Occupant Signature
am
pm
PID Number
House Number ' 2 Street Name i / ? /`' i i ✓
ii r/ � 2,2
/ Phone F 7 f - 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
N rnber ofsr?acks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Entered S L at
Time
•
am
pm
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 [ {'J
t _
Final Cleanout:
Pink Copy: SEH
Number Discharged
Note
,;� . -. i .: 1 ''
_
/ ,g = _ ;, '.._.
`� �r
Total
Correctly
Incorrectly Unknown
Sump pumps
1 1,17)
/
Foundation drains
Roof drains
'
City oi Fla p
Residential :Sanitary Sewer Service
Compliance Inspection
Date . f /
f
Name / 7
l�
4" to 6 " Transition:
Alternative Mailing Address
Compliance
O No foundation drain connection
O Sump p it not connected to
sanitary sewer
Sump pump properly piped
No sump pump
No roof drain connection
Service Lateral Inspection Findings
Roots
White Copy: Property Owner
Time
Disk#
Owner /Occupant Signature
am
pm
PID Number
House Number ' 2 Street Name i / ? /`' i i ✓
ii r/ � 2,2
/ Phone F 7 f - 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
N rnber ofsr?acks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Entered S L at
Time
•
am
pm
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition 1 [ {'J
t _
Final Cleanout:
Pink Copy: SEH