2106 Marble Lane - Inspection FormResiden Sanitary Sewer Service
Compliance Inspection
, }} i
Dater / t( // 1/
Name h tC Disk #
PID Number
House Number
Alternative Mailing Address
s`n
Street Name _ 2V
i
Time • o 7
/w
f Owner /Occupant Signature
am
pm
Phone N
Record Number
1.� L
Pm
e .
Inspector S ignature
For information call 651 470.2788
o� p lliance
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 Inspection Findings
Roots
1 1:7
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition --
4" to 6" Transition:
White Copy: Proper ty Owner
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
Obstruction
Unable to push past
feet
Number of stacks I Entered S.L.at
Length of Service:
Yellow Copy: City of Eagan
Notes
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
•a.
Pink Copy: SEH
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
%f )
Foundation drains
i`)
Roof drains`
Residen Sanitary Sewer Service
Compliance Inspection
, }} i
Dater / t( // 1/
Name h tC Disk #
PID Number
House Number
Alternative Mailing Address
s`n
Street Name _ 2V
i
Time • o 7
/w
f Owner /Occupant Signature
am
pm
Phone N
Record Number
1.� L
Pm
e .
Inspector S ignature
For information call 651 470.2788
o� p lliance
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 Inspection Findings
Roots
1 1:7
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition --
4" to 6" Transition:
White Copy: Proper ty Owner
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
Obstruction
Unable to push past
feet
Number of stacks I Entered S.L.at
Length of Service:
Yellow Copy: City of Eagan
Notes
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
•a.
Pink Copy: SEH