2013 Jade Lane - Inspection FormSump pumps
Foundation drains
f(
Roof drains
r
City or EapAR
Residentciai Sani> al"y Sewer Se vice
Compliance Inspection
Date //
Name - Disk #
PID Number
House Number : r i ) `--) Street Name
Alternative Mailing Address
Roots
No sump pump
4" to 6 "Transition:
For information call 651.470.2788
o pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Service Lateral Inspection Findings
/ --
-r
Poor Pipe joints
Mineral Deposits
f`S ag)Pipe Deflection
Damaged Pipe
Transition 2-) /
White Copy: Property Owner
OwnerlOccupant Signature
Total
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
Number of stacks _ f�
Correctly
Incorrectly Unknown
Length of Service:,
Yellow Copy: City of Eagan
Record Number
lime
inspector 'Signature
Obstruction
Unable to push past
feet
Notes
/14- Final Cleanout:
pm
m
Phone
No Access
O No one in
O Inspection
refused
O Access to service
lateral needed
L �
Entered S L at
Pink Copy: SEH