2080 Opal Dr - Inspection FormCity of tapo
Residential Sanitary Sever Service
Compliance Inspection
Date:.
Name /
PID Number
• Hoyse Number
A feipiative Maili
. 1
12l1 Y Disk #
f /
(
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
8 No sump pump
Time
Street Name
Service Lateral Inspection Findings
Roots
Transition ,1 (2)
4" to 6" Transition:
White Copy: Pr operty Owner
1
ng Address
)
k � �
r '.. •
Owner /Occupant Signature
i
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
% ?J Y
Time 1
Phone _
Inspector Signature
For information call .651 4
Length of Service: or,-",
Obstruction
Unable to push past
feet
Number of stacks Entered S.i. at
r
• o am
• _ pm
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Final Cleanout:
No Access
O No one in
O Access to service
Lateral needed
O Inspection
refused
Pink Copy: SEH
N
Correctly
Incorr ectly Unknown
Notes
Total
Sump pumps
Foundation drains
: -
Roof drains
;ms
City of tapo
Residential Sanitary Sever Service
Compliance Inspection
Date:.
Name /
PID Number
• Hoyse Number
A feipiative Maili
. 1
12l1 Y Disk #
f /
(
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
8 No sump pump
Time
Street Name
Service Lateral Inspection Findings
Roots
Transition ,1 (2)
4" to 6" Transition:
White Copy: Pr operty Owner
1
ng Address
)
k � �
r '.. •
Owner /Occupant Signature
i
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
% ?J Y
Time 1
Phone _
Inspector Signature
For information call .651 4
Length of Service: or,-",
Obstruction
Unable to push past
feet
Number of stacks Entered S.i. at
r
• o am
• _ pm
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Final Cleanout:
No Access
O No one in
O Access to service
Lateral needed
O Inspection
refused
Pink Copy: SEH