2105 Emerald Lane - Inspection FormCity or bon
Residential Sanitary Sewer Service
Compliance Inspection
Dat -/ /'
/ .6J
Time /f , •
Name_, ) '(r /f - -- Disk #
PID Number
/
House Number ,fW ' T Street Name
Alternative Mailing Address
No sump pump
o pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Owner /Occupant Signature
For information call 651:470.2788
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
1
am
Pm
1 C f
)(4 (.:17
Phone C:i' I Yf r72- `?°. 5 73
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
mber of <s
Record Number
Time I�
,bstruction
u. ,
inspector Signature
push past
feet
Not
• �f
),i; am
• o pm
No Access
O No one in
Length of Service: Z.-/ ` - 7 I Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Entered S . atc =� -
Roots "! ° , / 1 .,�.
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
•
4-1/43 / r< _ `'
3 f—
' 1 -- -
l I __-
Yellow Copy: City of Eagan} c /ruk Cody: EII
pia — 1)-
Total
Number Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City or bon
Residential Sanitary Sewer Service
Compliance Inspection
Dat -/ /'
/ .6J
Time /f , •
Name_, ) '(r /f - -- Disk #
PID Number
/
House Number ,fW ' T Street Name
Alternative Mailing Address
No sump pump
o pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Owner /Occupant Signature
For information call 651:470.2788
Service Lateral Inspection Findings
4" to 6" Transition:
White Copy: Property Owner
1
am
Pm
1 C f
)(4 (.:17
Phone C:i' I Yf r72- `?°. 5 73
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
mber of <s
Record Number
Time I�
,bstruction
u. ,
inspector Signature
push past
feet
Not
• �f
),i; am
• o pm
No Access
O No one in
Length of Service: Z.-/ ` - 7 I Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Entered S . atc =� -
Roots "! ° , / 1 .,�.
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
•
4-1/43 / r< _ `'
3 f—
' 1 -- -
l I __-
Yellow Copy: City of Eagan} c /ruk Cody: EII
pia — 1)-
Sump pumps
Foundation drains
.--
Roof drains
----
Residential Sanitary Sewer Service
Compliance Inspection
,
/
Name Disk #
i
PID Number
er
../
House Number
Street Name
Alternative Mailing Address
..„••
Owner/Occupant Signature
For information call 651.470.2788
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
Service Lateral lrisRect.n
, Nup)ber of cics Entered S L at
)
z7 6
Roots ./ii%; I
Poor PipeJoints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
LJ
Transition 2 - -- 7 /7„ - 7 L- C2)' ,6k
4" to 6"Transition:
Total
Zime
Q am
• / p
Correctly
CA,J
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 Discharged
incorrectly
Unknown
White qopy: Property Owner
Yellow Copy: City of Eagan „4 7
- 1 1
Record Number
•
0
Time •
I
Phone . , _.
•
Inspector Signature
Obstruction No Access
Una o push past 0 No one in
feet
Z-- r)
Length of Service: - • ' Final Cleanout:
Notes
-
am
pm
O Inspection
r efused
r
O Access to service
lateral needed
r.
Pink Copy: SEH
(k -3 7i