4358 Nicols Rd - Inspection FormP,
r City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name (J J
PID Number
House Number
Alternative Mailing Address
Com liance
No foundation drain connection
/s
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
b No sump pump
4" to 6" Transition:
v ?
White Copy: Property Owner
1
l �C
am
Time 7 • � pm
Disk #
- 4 ) - -_ Street Name
Owner /Occupant Signature
Non- Compliance
7,-t )1,
Length of Service:
Yellow Copy: City of Eagan
Record Number 1
T me
Phone (2 s
Obstruction
O Clear. water connections to Unable to push past
sanitary sewer feet
O Ser vice lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral In a ion Findings, Number of stacks a nte d S.L.at
, �, `�
Roots i ..- _ f _.__, _1, --r
...,--
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe / 1
Transition . [ to -�"�
J
•
o
inspector Signature
For information call 65 '.
�} .»Final Cleanout:
am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
( )
Foundation drains
Roof drains
-
-a L4 / )SMi/)
P,
r City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name (J J
PID Number
House Number
Alternative Mailing Address
Com liance
No foundation drain connection
/s
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
b No sump pump
4" to 6" Transition:
v ?
White Copy: Property Owner
1
l �C
am
Time 7 • � pm
Disk #
- 4 ) - -_ Street Name
Owner /Occupant Signature
Non- Compliance
7,-t )1,
Length of Service:
Yellow Copy: City of Eagan
Record Number 1
T me
Phone (2 s
Obstruction
O Clear. water connections to Unable to push past
sanitary sewer feet
O Ser vice lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral In a ion Findings, Number of stacks a nte d S.L.at
, �, `�
Roots i ..- _ f _.__, _1, --r
...,--
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe / 1
Transition . [ to -�"�
J
•
o
inspector Signature
For information call 65 '.
�} .»Final Cleanout:
am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH