2033 Jade Lane - Inspection FormSump pumps
_ �'
Foundation drains
Roof drains
City of.ta °
Residential Sanitary Sewer Service
Compliance Inspection
Dated -� 1 t(/�
i ) f
Name
PIE) Number / J
House Number 1•!. Street Name
Alternative Mailing Address-
For information call 651.470.2788
or 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
Service Lateral In gection Fipdi gs j J
Roots .:
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition t om; ?' Ir,! ° �
4" to 6" Transition:
White Copy: Property Owner
OwnerlOccupant Signature
Total
Time
C� • am
• pm
Disk #
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
Number of stacks . Entered S:L,at,1 .... ?
Length of Service:
Number Discharged
Correctly incorrectly Unknown
Yellow Copy: City of Eagan
Record Number
Phone
Notes
- • , -4;'3) am
71 - __ • O pm
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: 13
Pink Copy: SEH -,