2023 Shale Lane - Inspection FormCity off' Id an
y �
Residential Sanitary Sewer Service
Compliance Inspection
1—t
o
L
Date
1 r
j
C `
Name `< l 11 C
Time
Disk #
PID Number.
,) (-)
House Number �_ -! . Street Name
Alternative Mailing Address
f a
O er10 u ant Signature
Ern
Pm
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
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 Ins Findings Number of stacks
Roots (7) -+-
Poor Pipe Joints
MinerarDeposits
Sag /Pipe Deflection
Damaged Pipe
Transition ! 1 CJ
4" to 6"Transition: ()
White Copy: Property Owner
0
Yellow Copy: City of Eagan
Record Number
Entered S.L at
Length of Service:
1
e •c.2 .s O am
Time pm
Phone /7
Inspector Signature
Obstruction
Unable to push past
feet
/i
No Access
O No one in
Anal Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Total
Notes
.G j‘cits
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
c
tires
Foundation drains'
Roof drains
City off' Id an
y �
Residential Sanitary Sewer Service
Compliance Inspection
1—t
o
L
Date
1 r
j
C `
Name `< l 11 C
Time
Disk #
PID Number.
,) (-)
House Number �_ -! . Street Name
Alternative Mailing Address
f a
O er10 u ant Signature
Ern
Pm
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
'O Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
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 Ins Findings Number of stacks
Roots (7) -+-
Poor Pipe Joints
MinerarDeposits
Sag /Pipe Deflection
Damaged Pipe
Transition ! 1 CJ
4" to 6"Transition: ()
White Copy: Property Owner
0
Yellow Copy: City of Eagan
Record Number
Entered S.L at
Length of Service:
1
e •c.2 .s O am
Time pm
Phone /7
Inspector Signature
Obstruction
Unable to push past
feet
/i
No Access
O No one in
Anal Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH