2077 Jade Lane - Inspection Formlit al Ea afl
Residential Sanitary Sewer Service
Compliance Inspection
Date 05; I ?( ! / 2 Time .S :C
(/ l�j�
Name f ' Disk #
PID Number
House Number 2077 Street Name
Alternative Mailing Address
4" to 6 "Transition:
White Copy: Proper ty Owner
OwnerlOccupant Signature
Compliance
O No foundation drain connection
;Id roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
/ {. No sump pump
Service Lateral Inspection Findings Number of stacks
Roots �4/ I 7 �
r / 7
5
o am
(-
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:
Record Number f
-] I Time
7 J
Phon tom_ ? --r1 �� ` /tf.�V
l
/ Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
Entered S.L.at (
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection g _ 73 ' .51c" " 7C.) -
Damaged Pipe C 12A- C--3 iCr%...."N.1 ,y,'
Transition Z A % tr / �..� /4 y'''C-
Final Cleanout: ;fli�/��•�c,,t,
Notes Z.10 � a
- .
r
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
_______ _ ____
lit al Ea afl
Residential Sanitary Sewer Service
Compliance Inspection
Date 05; I ?( ! / 2 Time .S :C
(/ l�j�
Name f ' Disk #
PID Number
House Number 2077 Street Name
Alternative Mailing Address
4" to 6 "Transition:
White Copy: Proper ty Owner
OwnerlOccupant Signature
Compliance
O No foundation drain connection
;Id roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
/ {. No sump pump
Service Lateral Inspection Findings Number of stacks
Roots �4/ I 7 �
r / 7
5
o am
(-
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:
Record Number f
-] I Time
7 J
Phon tom_ ? --r1 �� ` /tf.�V
l
/ Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
Entered S.L.at (
O Access to service
lateral needed
O Inspection
refused
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection g _ 73 ' .51c" " 7C.) -
Damaged Pipe C 12A- C--3 iCr%...."N.1 ,y,'
Transition Z A % tr / �..� /4 y'''C-
Final Cleanout: ;fli�/��•�c,,t,
Notes Z.10 � a
- .
r
Yellow Copy: City of Eagan Pink Copy: SEH