2109 Marble Lane - Inspection FormCity of Eapit
Residential Sanitary Sewer Service-, .
Compliance Inspection
Date (97/ AV/ /i7
Name 77lb/ //M4' Disk #
PID Number
House Number. Z/0
Alternative Mailing Address
1
..a ;Owner /Occupant Signature
For information call. 65
Compliance
O 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 Lateral Inspection Findings Number of stacks 1 Entered St at
Roots 7 d - 1 7 f
/ I /
Poor Pipe Joints
Mineral Deposits y / ' r =J 3 77
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
White Copy: Property Owner
• Oam
Times? • (UD
Street Name
0
ll
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
-ff 7f c of Service:
Yellow Copy: City of Eagan
Record Number
c
Time >
o am
Aci pm
l Phone /) �,
Obstruction
Unable to push past
feet
inspector Signature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Number Discharged
Notes t'�7f C 4- 6 ezA./. s r r- J7.> -,
Z / . r; d. v j' e,
r Ad-c-.) /tow
( - 2 c ,
(
Total
Correctly
Incorrectly
Unknown
Sump um s e_
Foundation drains
Roof drains
-- —
_
City of Eapit
Residential Sanitary Sewer Service-, .
Compliance Inspection
Date (97/ AV/ /i7
Name 77lb/ //M4' Disk #
PID Number
House Number. Z/0
Alternative Mailing Address
1
..a ;Owner /Occupant Signature
For information call. 65
Compliance
O 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 Lateral Inspection Findings Number of stacks 1 Entered St at
Roots 7 d - 1 7 f
/ I /
Poor Pipe Joints
Mineral Deposits y / ' r =J 3 77
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6"Transition:
White Copy: Property Owner
• Oam
Times? • (UD
Street Name
0
ll
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
-ff 7f c of Service:
Yellow Copy: City of Eagan
Record Number
c
Time >
o am
Aci pm
l Phone /) �,
Obstruction
Unable to push past
feet
inspector Signature
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH