4398 Sandstone Dr - Inspection FormCity of Ja
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name Re....271q . '1 Disk #
PID Number
House Number -'- :7,) Street Name
Alternative Mailing Address
/7
Service Lateral
Roots
White Copy: Property Owner
1,
s It
OwnerlOccupant Signature
o piiance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6 "Transition: -' r�
Non - Compliance
O
O
O
O
O
am
Pm
r"
f! )
Phone's ._1 7 777
i,ofr9Fin i cings
r
"1 °--' --t-
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
J
Transition f . �' ��.
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
d
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
1'
Record Number 1
Ti me
Entered S.L at
Notes
• .
Inspector Signature
Obstruction
Unable to push past
feet.
'm
Pm
For information call 65:1 4703788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
• ''✓
c" -'
r { ,
Final Cleanout:
Pink Copy: SPH
Total
Number;
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
, /
Roof drains
City of Ja
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name Re....271q . '1 Disk #
PID Number
House Number -'- :7,) Street Name
Alternative Mailing Address
/7
Service Lateral
Roots
White Copy: Property Owner
1,
s It
OwnerlOccupant Signature
o piiance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6 "Transition: -' r�
Non - Compliance
O
O
O
O
O
am
Pm
r"
f! )
Phone's ._1 7 777
i,ofr9Fin i cings
r
"1 °--' --t-
Poor Pipejoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
J
Transition f . �' ��.
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
d
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
1'
Record Number 1
Ti me
Entered S.L at
Notes
• .
Inspector Signature
Obstruction
Unable to push past
feet.
'm
Pm
For information call 65:1 4703788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
• ''✓
c" -'
r { ,
Final Cleanout:
Pink Copy: SPH