2066 Quartz Lane - Inspection FormHouse Number
441111.
• city or Fa li
Residential Sanitary Sewer Service
Compliance Inspection
Date / 1 J l l Time
Name ) w , �; Disk #
PID Number
CO pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No .sump pump
Sag /Pipe Deflection
Damaged Pipe
� I (
Transition I (
White Copy: Property Owner
Owner /Occupant Signature
3 o7
��1!7 Street Name
06,,
p
m
Non - Compliance
1
4" to 6 "Transition: r r-- Length of Service:
Alternative Mailing Address Phone /
For information call 651.470.2788
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Findings N i;er of stacks / Entered S L at /�
Roots
Poor PipeJoints
Mineral Deposits
Record Number
Obstruction
n= oam
Tim tpm
/{
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan
#Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes
Sump pumps
MI.=
Foundation drains
MOM
Roof drains
0
House Number
441111.
• city or Fa li
Residential Sanitary Sewer Service
Compliance Inspection
Date / 1 J l l Time
Name ) w , �; Disk #
PID Number
CO pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No .sump pump
Sag /Pipe Deflection
Damaged Pipe
� I (
Transition I (
White Copy: Property Owner
Owner /Occupant Signature
3 o7
��1!7 Street Name
06,,
p
m
Non - Compliance
1
4" to 6 "Transition: r r-- Length of Service:
Alternative Mailing Address Phone /
For information call 651.470.2788
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Service Lateral Findings N i;er of stacks / Entered S L at /�
Roots
Poor PipeJoints
Mineral Deposits
Record Number
Obstruction
n= oam
Tim tpm
/{
Inspector Signature
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan
#Pink Copy: SEH