4617 Stonecliffe Dr - Inspection FormCit i Fa a
Residential Sanitary Sewer Service
Compliance Inspection
Date l / ? ./C1 • 9.e-dm
Time /
Name ( ,4 i -// " / e4 ?`f/
PID Number
House Number ' / 7 Street Name .4✓1 ; (- /-71
Alternative Mailing Address
For information call 651.470.2788
Compliance
No foundation drain connection
\ .
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
7
Disk #
e
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
Record Number
Notes
/ am
Time +
• • o pre
Phone ek 2 r" / C�
/inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S 1_ at c. Cc"
Length of Service: e % Final Cleanou
74C
r
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly Unknown
Sump pumps
II
Foundation drains
El II
---
MEI
MUM
Roof drains
Cit i Fa a
Residential Sanitary Sewer Service
Compliance Inspection
Date l / ? ./C1 • 9.e-dm
Time /
Name ( ,4 i -// " / e4 ?`f/
PID Number
House Number ' / 7 Street Name .4✓1 ; (- /-71
Alternative Mailing Address
For information call 651.470.2788
Compliance
No foundation drain connection
\ .
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
0 No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Owner /Occupant Signature
7
Disk #
e
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
Record Number
Notes
/ am
Time +
• • o pre
Phone ek 2 r" / C�
/inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S 1_ at c. Cc"
Length of Service: e % Final Cleanou
74C
r
Yellow Copy: City of Eagan Pink Copy: SEH
tit y of Fla
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
Name
PID Number
House Number
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
4
• r. i
White Copy: Proper Owner
• Q am
t i
Time h pm
Disk #
Street Name
OwnerlOccupant Signature
Alternative Mailing Address
Length of Service:
Yellow Copy: City of Eagan
f
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
Record Number j
Notes
Time
Number of stacks Entered S L at
I ? j ai t
Phone
Inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
Final Cleanout:
Oam
•
• OPm
l - r
r= jam'
r •
r
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
J
_ 1 -
Pink Copy: SEH
Total
Number Discharged
Correctly Incorrectly
--
Unknown
Sump pumps
Foundation drains
Roof drains
tit y of Fla
Residential Sanitary Sewer Service
Compliance Inspection
Date 1
Name
PID Number
House Number
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to 6" Transition:
4
• r. i
White Copy: Proper Owner
• Q am
t i
Time h pm
Disk #
Street Name
OwnerlOccupant Signature
Alternative Mailing Address
Length of Service:
Yellow Copy: City of Eagan
f
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
Record Number j
Notes
Time
Number of stacks Entered S L at
I ? j ai t
Phone
Inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
Final Cleanout:
Oam
•
• OPm
l - r
r= jam'
r •
r
O Access to service
lateral needed
O Inspection
refused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
J
_ 1 -
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance Inspection
Date /A /c
Name . 41-/.,/, / A./ . Az e #
PD Number
House Number
4" to 6" Transition:
W/
7
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Chimer
• . earn
Time c." • 6 ci pm
Street Name
Owner/Occupant Signature
Non-Compliance
0
0
0
0
Alternative Mailing Address
cw6
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone e? Try
Time
• 0 am
• 0 Pm
:inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe_
Transition
Final C I eanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/frei2 /44,447
Pink Copy: SEH
Total
Number
Discharged
Correctly
lncorr ectly
Unknown
Sump pumps
Foundation drains
I.
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date /A /c
Name . 41-/.,/, / A./ . Az e #
PD Number
House Number
4" to 6" Transition:
W/
7
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Chimer
• . earn
Time c." • 6 ci pm
Street Name
Owner/Occupant Signature
Non-Compliance
0
0
0
0
Alternative Mailing Address
cw6
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone e? Try
Time
• 0 am
• 0 Pm
:inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe_
Transition
Final C I eanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
/frei2 /44,447
Pink Copy: SEH
Residential Sanitary Sewer Service
Compliance Inspection
Date& / / C \ •i / G'
f ▪ ,
Name •
e
PID Number
House Number i r;/ Street Name J ' 'l
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof dram connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6"Transition:
White Copy: Proper ty Owner
Time L r • e
Owner /Occupant Signature
.6 "am
O pm
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:
Yellow Copy: City of Eagan
Record Number
Time
Phone 'L ,/
- ;inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cfeanout:
• O am
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
DWI
Number Discharged
Unknown
Notes
Total
Correctly
Incorrectl
e.
c. '&1e
Surnp pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date& / / C \ •i / G'
f ▪ ,
Name •
e
PID Number
House Number i r;/ Street Name J ' 'l
Alternative Mailing Address
Compliance
O No foundation drain connection
O No roof dram connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6"Transition:
White Copy: Proper ty Owner
Time L r • e
Owner /Occupant Signature
.6 "am
O pm
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:
Yellow Copy: City of Eagan
Record Number
Time
Phone 'L ,/
- ;inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Final Cfeanout:
• O am
• O pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Pink Copy: SEH
DWI