2013 Bluestone Lane - Inspection Formrit,y FaRaii
Residential Sanitary Sewer Service
Compliance Inspection
Date 651 / /C?
Name 4 ( F -v /7/
PID Number
House Number
Alternative Mailing Address
)N o - foundation drain connection
Q r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to b" Transition:
�% • , 'am
Time • O pm
Disk #
Street Name
Owner /Occupant Signature
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
Service Lateral Inspec 'on Findings
Roots 7
rf
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number of stacks °i Entered 5 L.at
Length of Service:
White Copy. Property Owner Yellow Copy: City of Eagan
/ r�
( / G,17V f ,A1f (/ -, Zr Tiffoli/
f .
Record Number
e = J 6- !tom' ✓ �
Pone rte" /)
-4 7 /
For information call 6511470.2788
' __ /lnspectar Signature
Obstruction
Unable to push past
feet
Notes Z 4
r
^ 1. > 't�L if ,{ /1/ /''i 1 % r?, f ' '
� r
&t40
C / J%! t' Copy: SEH
—/1'
/1 • I / $ : o am
Time ® 1 O Pm
No Access
O No one in
,573,40c-- City
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout: s`> /V/i Jf
NurviberDischarged
Correctly
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
(
rit,y FaRaii
Residential Sanitary Sewer Service
Compliance Inspection
Date 651 / /C?
Name 4 ( F -v /7/
PID Number
House Number
Alternative Mailing Address
)N o - foundation drain connection
Q r No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to b" Transition:
�% • , 'am
Time • O pm
Disk #
Street Name
Owner /Occupant Signature
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
Service Lateral Inspec 'on Findings
Roots 7
rf
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number of stacks °i Entered 5 L.at
Length of Service:
White Copy. Property Owner Yellow Copy: City of Eagan
/ r�
( / G,17V f ,A1f (/ -, Zr Tiffoli/
f .
Record Number
e = J 6- !tom' ✓ �
Pone rte" /)
-4 7 /
For information call 6511470.2788
' __ /lnspectar Signature
Obstruction
Unable to push past
feet
Notes Z 4
r
^ 1. > 't�L if ,{ /1/ /''i 1 % r?, f ' '
� r
&t40
C / J%! t' Copy: SEH
—/1'
/1 • I / $ : o am
Time ® 1 O Pm
No Access
O No one in
,573,40c-- City
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout: s`> /V/i Jf