2134 Shale Lane - Inspection Formr City of Eagan
Residential Sanitary Sewer Service
Compliance Inspection
Date C / C.7 / /
Name 403-0 f7 1
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
"Sump pump properly piped
O No sump pump
Service Lateral Ilnspection Findings Number of stacks ered S.L. at
C
Roots ;'� �,- G��, /c/�� °-- I.�J .�' 7
i
Poor Pipe
Joint
si fi
Mineral Deposits
Sag /Pipe Deflection - '(
-
Damaged Pipe j f
Transition � A / /t.) /� (-I r�` �' ( ice C�
4" to 6 "Transition:
White Copy: Proper ty.. Owner
OwnerlOccupant Signature
, /A
Time 62 • - • �' o
Disk #
0
Street Name
am
pm
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
r
Ent
Length oService:
Record Number --CS
Time 0k
T n pector Signature
Obstruction
Unable to push past
feet
• 41- Olam
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
J N otes C o
frik4r-ePJ
Yellow Copy: City of Eagan Pink Copy: SEE
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
1
1
Foundation drains
Roof drains
.
r City of Eagan
Residential Sanitary Sewer Service
Compliance Inspection
Date C / C.7 / /
Name 403-0 f7 1
PID Number
House Number
Alternative Mailing Address
For information call 651.470.2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
"Sump pump properly piped
O No sump pump
Service Lateral Ilnspection Findings Number of stacks ered S.L. at
C
Roots ;'� �,- G��, /c/�� °-- I.�J .�' 7
i
Poor Pipe
Joint
si fi
Mineral Deposits
Sag /Pipe Deflection - '(
-
Damaged Pipe j f
Transition � A / /t.) /� (-I r�` �' ( ice C�
4" to 6 "Transition:
White Copy: Proper ty.. Owner
OwnerlOccupant Signature
, /A
Time 62 • - • �' o
Disk #
0
Street Name
am
pm
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
r
Ent
Length oService:
Record Number --CS
Time 0k
T n pector Signature
Obstruction
Unable to push past
feet
• 41- Olam
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
J N otes C o
frik4r-ePJ
Yellow Copy: City of Eagan Pink Copy: SEE