2093 Jade Lane - Inspection FormSump pumps
I
Foundation drains
._`_______
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Roof drains
City o1 Ea a
Residential Sanitary Sewer Service
Compliance Inspection
Date a) 1 //o
Name Jib"% ` /c°r1
Disk #
PID Number
Alternative Mailing Address
6./
Compliance
r
r No foundation drain connection
' , No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
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it/
7,6/
Time r/ �
iI
s
o ant
o pm
Number of stacks
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
0
Record Number
Time /
House Number Street Name /'lt
/_(/)
Phone e f ' -
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
o „ Length of Service: oC
a
r ,
,f ' /Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
;dam
o pm
No Access
O No one in
r,�
Entered S L at .� '_f: - c J
O Access to service
lateral needed
O Inspection
refused
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe_
Transition
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Notes , op/ 6, r
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1� Pink Copy: SEH