2053 Quartz Lane - Inspection Formcity of mpg
•
Residential Sanitary Sewer Service
Compliance Inspection
{•
Date l )
m
Name •. ,. k i r Disk #
PID Number
c2 ,,---
House Number Street Name
Alternative Mailing Address
Owner/Occupant Signature
For information call 651.470:2788
orr� pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service 1 al
Roots
Poor Pipejoints
• am
Time • pm
s pection Findings /� Nrgbe
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
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
J_�,
Transition
4" to 6 "Transition:
White Copy: Property Owner
i:\? ) <;
Phone r LI J " C >_
of stacks
Length of Service:
c_
Yellow Copy: City of Eagan
Record Number 7
Entered S, L at
am
Time pm
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
) —5—
ii
Il
-y Final Cleanout:
Pink Copy: SEH
.." VAL i.---
I
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
r
Roof drains
city of mpg
•
Residential Sanitary Sewer Service
Compliance Inspection
{•
Date l )
m
Name •. ,. k i r Disk #
PID Number
c2 ,,---
House Number Street Name
Alternative Mailing Address
Owner/Occupant Signature
For information call 651.470:2788
orr� pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service 1 al
Roots
Poor Pipejoints
• am
Time • pm
s pection Findings /� Nrgbe
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
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
J_�,
Transition
4" to 6 "Transition:
White Copy: Property Owner
i:\? ) <;
Phone r LI J " C >_
of stacks
Length of Service:
c_
Yellow Copy: City of Eagan
Record Number 7
Entered S, L at
am
Time pm
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
) —5—
ii
Il
-y Final Cleanout:
Pink Copy: SEH