2093 Copper Lane - Inspection FormSump pumps
Tf
Foundation drains
Roof drains
City Di' Eagan
Residential Sanitary Sewer Service
Compliance Inspection
Date l
Nam
.1)./47.-2-77)
PO Number
House Number -~ Street Name
Alternative Mailing Address
774
j Owner /Occupant Signature
For information call 651:4701788
Compliance
o foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
4" to 6 "Transition:
Total
Z,
am
Time J• ! pm
Disc #
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
f
Length of Service:
Correctly incorrectly Unknown
Number of stacks ? Entered S L at
Number Discharged
White Copy: Property Owner
;7
Record Nun'iber
Time
Obstruction
Unable to push past
feet
Inspector Signature
am
o pm
01:
w fr
Phone 7 �.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
I c_: „ ) c _ .-; 6,
F Cleanout: �.
Yellow Copy: City of Eagan Piuk Copy: SEH