4083 Diamond Dr - Inspection Formcity 0
Residential Sanitary Sewer Service
Compliance Inspection
Date 1 )_I r'f
v
Time
Name
PID Number
House Number
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
Alternative Mailing Address
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Service Lateral Inspection Findings
Roots
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
i
_1
Total
Disk #
2"
Street Name
Ownerl0c ant - Signature
Correctly
am
pm
C[�
For information call 651.470.2788
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
Poor Pipe Joints
Length of Service:
Number Discharged
Incorrectly
Unknown
Yellow Copy: City of Eagan
Record Number
Phone
Obstruction
Unable to push past
feet
Errered S. L at
Notes
el
Time
Inspector Signature
o a
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
t 1J
f
2,
Final Cleanout:
r
Pink Copy: SEH