2133 Jade Pt - Inspection FormCity oI an
Residentia.I Sanitary Sewer Service
Compliance Inspection
Date/,-'. 1 1
Name if ! J � i_,) Disk #
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
4" to b" Transition:
::: -White Copy: Property Owner
�._3C am
Time + "• A pm
PID Number
House Number ,,- r ._ _? Street Name
Alternative MailingA, d
\wnerlOccupant Signature
Compliance
0 No foundation drain connection
i
0 No sump pump
-LLB
Phone _.
Inspector Signature
For information call 65
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
Service Lateral inspection Findings
Roots / , c_�
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition• 4"
Number of stacks !. Entered S,L.at
Length of Service:
Yellow Copy: City of Eagan_
Record Number
l f
F
Time
Obstruction
Unable to push past
feet.
/ 15inal Cleanout:
am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Noes
64/
yy 7 �` 4
Pink Copy: SEH
-4-
Number:
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
X
Foundation drains
drains
) Roof
City oI an
Residentia.I Sanitary Sewer Service
Compliance Inspection
Date/,-'. 1 1
Name if ! J � i_,) Disk #
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
4" to b" Transition:
::: -White Copy: Property Owner
�._3C am
Time + "• A pm
PID Number
House Number ,,- r ._ _? Street Name
Alternative MailingA, d
\wnerlOccupant Signature
Compliance
0 No foundation drain connection
i
0 No sump pump
-LLB
Phone _.
Inspector Signature
For information call 65
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
Service Lateral inspection Findings
Roots / , c_�
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition• 4"
Number of stacks !. Entered S,L.at
Length of Service:
Yellow Copy: City of Eagan_
Record Number
l f
F
Time
Obstruction
Unable to push past
feet.
/ 15inal Cleanout:
am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Noes
64/
yy 7 �` 4
Pink Copy: SEH
-4-