4103 Diamond Dr - Inspection FormCity of Ea a i
Residential Sanitary Sewer. Service
Compliance Inspection
0 am
Date 4 / , t2 / Time .J • e0 wpm
Name ,1/6( • Disk#
PID Number
House Number
Alternative Mailing Address
(. \\i'iA
compliance
O'No foundation drain connection
7 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
.kp No sump pump
Service Lateral Inspection Findings Number of stacks
Roots >)-
Poor Pipe Joints
Mineral Deposits -
Sag/Pipe Deflection ° — 0 -
Damaged Pipe /
Transition /
4" to 6 "Transition:
White Copy: Property Owner
Street Name
5 Owner /Occupant Signature
-L/12]
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
/i _
Length of Service:
Record Number
fime /
® 0 am
® 0 , or,
Phone , .'.. , : - /i)
V inspector Signature
For information call 65
Obstruction
Unable to push past
feet
Entered S L at # z�
•
•
(79g f",k15
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: ! r
/
-..r F
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discharged
Correctly Incorrectly
IIIIM
Unknown
Sump pumps
/
Foundation drains
•-- -
Roof drains
� .,r
City of Ea a i
Residential Sanitary Sewer. Service
Compliance Inspection
0 am
Date 4 / , t2 / Time .J • e0 wpm
Name ,1/6( • Disk#
PID Number
House Number
Alternative Mailing Address
(. \\i'iA
compliance
O'No foundation drain connection
7 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
.kp No sump pump
Service Lateral Inspection Findings Number of stacks
Roots >)-
Poor Pipe Joints
Mineral Deposits -
Sag/Pipe Deflection ° — 0 -
Damaged Pipe /
Transition /
4" to 6 "Transition:
White Copy: Property Owner
Street Name
5 Owner /Occupant Signature
-L/12]
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
/i _
Length of Service:
Record Number
fime /
® 0 am
® 0 , or,
Phone , .'.. , : - /i)
V inspector Signature
For information call 65
Obstruction
Unable to push past
feet
Entered S L at # z�
•
•
(79g f",k15
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: ! r
/
-..r F
Yellow Copy: City of Eagan Pink Copy: SEH