2085 Emerald Lane - Inspection FormCity of Ca as
Residential Sanitary Sewer Service
Compliance Inspection
j
Date%i 1 /
Name ) m
PID Number
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
Sump pumps
Foundation drains
Roof drains
Disk #
Total
; i
Street Name
House Number
-
Alternative Mailing Address
OwnerlOccupant Signature
Correctly Incorrectly
Length of Service:
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
Unknown
White Copy: Property Owner Yellow Copy: City of Eagan
Record Number
1,!
Time
l ?
Phone �
/
__.
For information call 651.470.2788
Service Latera In spection Findings i f Number of stacks ` Entere S .L. at � .! � ., J ,0 t
Roots , i ? Y
Poor Pipe Joints
Mineral Deposits
1 r
Sag /Pipe Deflection
Damaged Pipe
y 1'
1 F
Transition 4-4- � (Y - r
•
Notes
Obstruction
Unable to push past
feet
Inspector Signature
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
oam
r pm
Final Cleanout:
1 ' J
Pink Copy: SEH