2070 Bluestone Dr E - Inspection FormCity a[ to
Residential Sanitary Sewer Service
Compliance Inspection
o a
Date r9 I ' � /G _ Time . �J; fp m
Name AL // AA/A f _Disk #
PID Number
House Number 76) Street Name
Alternative Mailing Address
J
Owner /Occupant Signature
For information call 651.470:2788
Compliance
0\No foundation drain connection
9/No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection "
Damaged Pipe ( 7 2 T
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
Record Number
I`:< :_.fX2A" 2)e G
Number of stacks ? Entered S at _ e 7 7- _ ' 7a
Transition - 4 , I ( N -- 7 Ai SE " "
4" to 6"Transition:
Length of Service: 71-
White Copy Piopeity Owner
Time ( • KO pm
Ph
.f
r ;inspector Signature
Obstruction
Unable to push past
feet
z — 7 l
Final Cleanout:
Notes - �?. V
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
.
Correctly
Incorrectly
Unknown
Sump pumps
,, -�
—
Foundation drains
}
``-
Roof drains
i
City a[ to
Residential Sanitary Sewer Service
Compliance Inspection
o a
Date r9 I ' � /G _ Time . �J; fp m
Name AL // AA/A f _Disk #
PID Number
House Number 76) Street Name
Alternative Mailing Address
J
Owner /Occupant Signature
For information call 651.470:2788
Compliance
0\No foundation drain connection
9/No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection "
Damaged Pipe ( 7 2 T
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
Record Number
I`:< :_.fX2A" 2)e G
Number of stacks ? Entered S at _ e 7 7- _ ' 7a
Transition - 4 , I ( N -- 7 Ai SE " "
4" to 6"Transition:
Length of Service: 71-
White Copy Piopeity Owner
Time ( • KO pm
Ph
.f
r ;inspector Signature
Obstruction
Unable to push past
feet
z — 7 l
Final Cleanout:
Notes - �?. V
No Access
O No one in
O Access to service
lateral needed
O inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH