4040 Rahn Rd - Inspection FormCity of to o
Residential `Sanitary Sewer Service
Compliance inspection
)1
1
Name
Date
Time
Disk #
, pam
• Q'pm
PID Number
House Number i t ; Street Name
Alternative Mailing Address
,......
Phone F < S -... - ' „c '_ r^
7--:
1 _,:=7„,...;_.,,.....,,,,/,,,-4.---, ;%� Owner /Occupant Signature Inspector Signature
For information call 651 2788
orx 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
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
Ser vice Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ti
Transition ' - ' - r
4" to 6 "Transition:
White Copy: Property Owner
Number of stacks Entered S L at
a)7)
Length of Service: a
Yellow Copy: City of Eagan
Record Number
Th
Obstruction
Unable to push past
feet
Notes
i
Time l s
y r
Final Cleanout:
0 am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number Discharged
Total
Correctly Incorrectly
Unknown
Sump pumps
Foundation drains
.
Roof drains
City of to o
Residential `Sanitary Sewer Service
Compliance inspection
)1
1
Name
Date
Time
Disk #
, pam
• Q'pm
PID Number
House Number i t ; Street Name
Alternative Mailing Address
,......
Phone F < S -... - ' „c '_ r^
7--:
1 _,:=7„,...;_.,,.....,,,,/,,,-4.---, ;%� Owner /Occupant Signature Inspector Signature
For information call 651 2788
orx 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
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
Ser vice Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
ti
Transition ' - ' - r
4" to 6 "Transition:
White Copy: Property Owner
Number of stacks Entered S L at
a)7)
Length of Service: a
Yellow Copy: City of Eagan
Record Number
Th
Obstruction
Unable to push past
feet
Notes
i
Time l s
y r
Final Cleanout:
0 am
pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH