2083 Opal Dr - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date ' 2Cf (rF I
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
to 6" Transition: y
Name � � t f
ti ' 46-7 Disk #
/ • �" 'e-am
Time • • •` p pm
PID Number
House Number � Street Name
C7/
Alternative Mailing Address t
bwner /Occupant Signature
For information call 651.470.2788
pliance
No foundation drain connection
No roof drain connection
f)
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Q / No sump pump
t
White Copy: Property Owner
Non - Compliance
O
Service Lateral inspection Findings
Roots
O
O
O
0
V
5
Clear water connections to
sanitary sewer
Service lateral defects
Defective rnanholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
f
j
Yellow Copy: City of Eagan
Record Number ('
I % ;(7'am
• Time • o pm
ry�
Phong "�� r •2 w f
tt
Trisect Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
Entered S,
O Access to service
lateral needed
O Inspection
refused
Notes
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
---
Foundation drains
M.
Roof drains
--------
Residential Sanitary Sewer Service
Compliance Inspection
Date ' 2Cf (rF I
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
to 6" Transition: y
Name � � t f
ti ' 46-7 Disk #
/ • �" 'e-am
Time • • •` p pm
PID Number
House Number � Street Name
C7/
Alternative Mailing Address t
bwner /Occupant Signature
For information call 651.470.2788
pliance
No foundation drain connection
No roof drain connection
f)
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Q / No sump pump
t
White Copy: Property Owner
Non - Compliance
O
Service Lateral inspection Findings
Roots
O
O
O
0
V
5
Clear water connections to
sanitary sewer
Service lateral defects
Defective rnanholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks
Length of Service:
f
j
Yellow Copy: City of Eagan
Record Number ('
I % ;(7'am
• Time • o pm
ry�
Phong "�� r •2 w f
tt
Trisect Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
Entered S,
O Access to service
lateral needed
O Inspection
refused
Notes
Pink Copy: SEH