2096 Garnet Lane - Inspection FormCity of lia as
�ies'den�lal Sanitary .Sewer entice
Compliance Inspection
/? 7
Date ' l / 1 i 1 _1' )
+ rte Y ! !:7 1 ,-
Name . + ✓ ? _
PID Number
House Number
Alternative Mailing Address
/
For .information c all 651:470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
/ ` sanitary sewer
O Sump pump properly piped
O No sump pump
{
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
'Sa P e Deflection
Damaged Pipe
Transition
Owner /Occupant Signature
4" to 6 "Transition:
White Copy: Property Owner
• am
Time / • 'o pm
Street Name
Disk #
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
Length of Service:
Record Number _ !
am
0 pm
Notes
Time
Obstruction
Unable to push past
feet
r)
Phone. E 7:) �? �
Inspector Signature
Number of stacks _ Entered S.L.at '27/7:
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
• Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
f i
Foundation drains
/ 2
Roof drains
j
City of lia as
�ies'den�lal Sanitary .Sewer entice
Compliance Inspection
/? 7
Date ' l / 1 i 1 _1' )
+ rte Y ! !:7 1 ,-
Name . + ✓ ? _
PID Number
House Number
Alternative Mailing Address
/
For .information c all 651:470.2788
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
/ ` sanitary sewer
O Sump pump properly piped
O No sump pump
{
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
'Sa P e Deflection
Damaged Pipe
Transition
Owner /Occupant Signature
4" to 6 "Transition:
White Copy: Property Owner
• am
Time / • 'o pm
Street Name
Disk #
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
Length of Service:
Record Number _ !
am
0 pm
Notes
Time
Obstruction
Unable to push past
feet
r)
Phone. E 7:) �? �
Inspector Signature
Number of stacks _ Entered S.L.at '27/7:
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH