4259 Jasper Dr - Inspection FormC i t y off' ,a a
Residential Sanitary Sewer Service
Compliance inspection
Date / t 3
Name 1 „ 7
PID Number
2_ . /
9 %7
House Number )--7 Street Name
Alternative Mailing Address
For information call 651
Compliance
No foundation drain connection
No roof drain connection
r
D Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1 ,
'Transition I
4" to 6" Transition:
White Copy: Property Owner
Disk #
Time •
Owner /Occupant Signature
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
am
0 pm
Length of Service:
r� =!'
Phone
Yellow Copy: City of Eagan
Record Number
.
• am
Time • o pm
Entered S. L at
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in'`
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: /7"
/
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
i
Foundation drain
Roof drains
C i t y off' ,a a
Residential Sanitary Sewer Service
Compliance inspection
Date / t 3
Name 1 „ 7
PID Number
2_ . /
9 %7
House Number )--7 Street Name
Alternative Mailing Address
For information call 651
Compliance
No foundation drain connection
No roof drain connection
r
D Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
1 ,
'Transition I
4" to 6" Transition:
White Copy: Property Owner
Disk #
Time •
Owner /Occupant Signature
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
am
0 pm
Length of Service:
r� =!'
Phone
Yellow Copy: City of Eagan
Record Number
.
• am
Time • o pm
Entered S. L at
Inspector Signature
Obstruction
Unable to push past
feet
No Access
O No one in'`
O Access to service
lateral needed
O Inspection
refused
Final Cleanout: /7"
/
Pink Copy: SEH