2077 Quartz Lane - Inspection Form6
City i)1 tapri
Residential Sanitary Sewer Service
Compliance Inspection
Date? .. )//Th/
,
Name / 10.. 1,141/0 Disk #
—7'116'300 am
Time • 'o pm
PID Number
House Number Street Name
Alternative Mailing Address
r /
Owner/Occupant Signature
Corn fiance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Poor Pipejoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition 77 -7 79
4" to 6" Transition:
White Copy: Property Owner
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
Service Lateral Inspection Findings Number of stacks
Roots
Length of Service:
/4-
1
Yellow Copy: City of Eagan
Record Number
Time
5 l
Obstruction
Unable to push past
feet
arn
�Z o pm
•
Phone .
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered 5 L at
f 4Final Cleanout:
1
Pink Copy; SEH
Number Discharged
Notes
Total
Correctly
Incorrectly
Unknown
pumps
1 '
Foundation drains
I),
1 ,.....,../
Roof drains
6
City i)1 tapri
Residential Sanitary Sewer Service
Compliance Inspection
Date? .. )//Th/
,
Name / 10.. 1,141/0 Disk #
—7'116'300 am
Time • 'o pm
PID Number
House Number Street Name
Alternative Mailing Address
r /
Owner/Occupant Signature
Corn fiance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Poor Pipejoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition 77 -7 79
4" to 6" Transition:
White Copy: Property Owner
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
Service Lateral Inspection Findings Number of stacks
Roots
Length of Service:
/4-
1
Yellow Copy: City of Eagan
Record Number
Time
5 l
Obstruction
Unable to push past
feet
arn
�Z o pm
•
Phone .
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered 5 L at
f 4Final Cleanout:
1
Pink Copy; SEH