4184 Topaz Dr - Inspection FormCity of liapo
Residential Sanitary Sewer Service
Compliance Inspection
Date_ 1 f 1 /` j
Name `7
)4/16}
PID Number.
House Number ) Street Name
Alternative Mailing Address
O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
Roots
No sump pump
4" to 6" Transition:
White Copy: Property Owne
�..'� 9 am
Time • pm
Disk#
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Service Lateral Inspection Findings
J l
"a
r
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
Yellow Copy: City of Eagan
Record Number
/Length of Service: �, • t
Time • _
am
pm
Phone
Inspector Signature
For information call 651.470.2788
Unablgyo push past
}feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stack • Entered S L. at
• 1 s�
Poor Pipe Joints
Mineral Deposits i 7:I'
7 ') f'`'' - •. '" C r'l �. '- , " (:_i.- k-: .�'
- 7) -„ '7? ` -
Sag /Pipe Deflection ' - de-" -4-j ( t �, 7 t , ¢ L
1
Damaged Pipe ! / 4,- 3.' 7 ? 7,' - .af?( t `' : � s _ ? 1 1 ,
t,
Transition {'1 - 7o' r " " �- w f.-s " )
t
4 �
;Final Cleanout: � 2 . l
Pink Copy: SEH
Notes
Number Discharged 1 2 \ / if -r '--,_ •
Total
Correctly
Incorrectly Unknown
/ i
/c / I .--= 3 ,` _.
,.
Sump pumps
Foundation drains
Roof drains
1
City of liapo
Residential Sanitary Sewer Service
Compliance Inspection
Date_ 1 f 1 /` j
Name `7
)4/16}
PID Number.
House Number ) Street Name
Alternative Mailing Address
O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
Roots
No sump pump
4" to 6" Transition:
White Copy: Property Owne
�..'� 9 am
Time • pm
Disk#
Owner /Occupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
Service Lateral Inspection Findings
J l
"a
r
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
Yellow Copy: City of Eagan
Record Number
/Length of Service: �, • t
Time • _
am
pm
Phone
Inspector Signature
For information call 651.470.2788
Unablgyo push past
}feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stack • Entered S L. at
• 1 s�
Poor Pipe Joints
Mineral Deposits i 7:I'
7 ') f'`'' - •. '" C r'l �. '- , " (:_i.- k-: .�'
- 7) -„ '7? ` -
Sag /Pipe Deflection ' - de-" -4-j ( t �, 7 t , ¢ L
1
Damaged Pipe ! / 4,- 3.' 7 ? 7,' - .af?( t `' : � s _ ? 1 1 ,
t,
Transition {'1 - 7o' r " " �- w f.-s " )
t
4 �
;Final Cleanout: � 2 . l
Pink Copy: SEH
4 11111. . City i� Ea
go
g
Residential Sanitary Sewer Service
Compliance Inspection
Date ) . 1 '1.x'
Name (7/.."
r' ° Disk #
r$
PID Number
House Number A Street Name
Transition
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Alternative Mailing Address
Compliance
O No foundation drain connection
O 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
Roots
7
4" to 6" Transition:
White Copy: Property Owner
` 1
OwnerlOccupant S gnature
am
pm
Number
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
/•r /";
t j •_ f , o am
Time _•�- • pm
T)/'
g
Phone% ' n !
Obstruction
Unable to push past
feet.
1}
rr
Inspector Signature
} ) Z 3
For information call 651.470.2788
f stacks I Entered S.L.at -"
1 Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f
Pink Copy: SEH
Number
Correctly
Discharged
Notes
i !. i�
,-
i G am _ ° f [ °� �c '
7/
Total
Incorrectly
Unknown
Sump pumps
/
Foundation drains s
,�) j ?=
, i .„...
__
Roof drains
, �'
1 `' -�
I
4 11111. . City i� Ea
go
g
Residential Sanitary Sewer Service
Compliance Inspection
Date ) . 1 '1.x'
Name (7/.."
r' ° Disk #
r$
PID Number
House Number A Street Name
Transition
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Alternative Mailing Address
Compliance
O No foundation drain connection
O 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
Roots
7
4" to 6" Transition:
White Copy: Property Owner
` 1
OwnerlOccupant S gnature
am
pm
Number
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
/•r /";
t j •_ f , o am
Time _•�- • pm
T)/'
g
Phone% ' n !
Obstruction
Unable to push past
feet.
1}
rr
Inspector Signature
} ) Z 3
For information call 651.470.2788
f stacks I Entered S.L.at -"
1 Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f
Pink Copy: SEH