2062 Jade Lane - Inspection FormCity or Papa
Residential Sanitary Sewer Service
Compliance Inspection
Date (9 72. / Time • o am
/ 7 • trpm
Name 2:?&744/ /4
PID Number
House Number <2,<" 2 Street Name _7
Alterative Mailing Address
/
/ • /4/
flA,/
o pliance
4" to 6" Transition:
Owner/Occupant Signature
ir iS'WolarrdairetydrraNtonin90 on
K
p, No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
6
Length of Service:
Record Number ZJ
0
Phone
h
/ ' 4 /
ilitispector Signature
For information call 651.470.2788
Non-Compliance
O Clear water connections to
sanitary sewer.
O Service lateral defects
O Defective manholes
tO: Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Obstruction
Unable to push past
feet
Service LateFal. Inspection Findings Number of stacks Entered S L at J
Roots 1 7
Yellow Copy: City of Eagan
Time / •
C$0
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
- -
Poor Pipe Joints
•./
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition -1 C(-/f
Final Cleanout: 4
Pink Copy: SEH
Total
Notes
- D
) Ai
.1.-)! r, 27:.
, 1
j ..,
'
7-, )
:.--,..3.
D 1 _.S
t
- /,,,i _ I
1)
....i
x -----
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
2..._
it
Foundation drains
.
Lc
&711-Pe r±:QA/CD
Roof drains
_
City or Papa
Residential Sanitary Sewer Service
Compliance Inspection
Date (9 72. / Time • o am
/ 7 • trpm
Name 2:?&744/ /4
PID Number
House Number <2,<" 2 Street Name _7
Alterative Mailing Address
/
/ • /4/
flA,/
o pliance
4" to 6" Transition:
Owner/Occupant Signature
ir iS'WolarrdairetydrraNtonin90 on
K
p, No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
6
Length of Service:
Record Number ZJ
0
Phone
h
/ ' 4 /
ilitispector Signature
For information call 651.470.2788
Non-Compliance
O Clear water connections to
sanitary sewer.
O Service lateral defects
O Defective manholes
tO: Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Obstruction
Unable to push past
feet
Service LateFal. Inspection Findings Number of stacks Entered S L at J
Roots 1 7
Yellow Copy: City of Eagan
Time / •
C$0
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
- -
Poor Pipe Joints
•./
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition -1 C(-/f
Final Cleanout: 4
Pink Copy: SEH