2108 Shale Lane - Inspection FormW
Nei
Residential Sanitary Sewer Service
Compliance inspection
Date! {, /
Name dizrY,9 4/' r
PID Number
House Number
Alter native Mailing Address
7
Time
Disk #
Street Name
-am
,-' 1 o pm
` . Owner /Occupant Signature ;
- Z�- LJJ
/ 014,
For information call 651:470 2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
•
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
Service Lateral Inspection Findings
Roots .`
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
• /am
Time 2 7 • -,- o pm
P ne✓�
t f 4 inspector Signature
\... / ,
Obstruction
Unable to push past
feet
Number of stacks 1 Entered S.L.. at j i?
Notes
/J
•
Final Cleanout:
n
:( ) ..?
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
s
d,J
F ..
Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
S ump pumps
. , v . M __.,....__..
- -m
—
Foundation drains
Roof drain's
'
�,fe
_... __"`
W
Nei
Residential Sanitary Sewer Service
Compliance inspection
Date! {, /
Name dizrY,9 4/' r
PID Number
House Number
Alter native Mailing Address
7
Time
Disk #
Street Name
-am
,-' 1 o pm
` . Owner /Occupant Signature ;
- Z�- LJJ
/ 014,
For information call 651:470 2788
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
4" to 6" Transition:
•
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
Service Lateral Inspection Findings
Roots .`
Poor Pipe joints
Mineral Deposits
SaglPipe Deflection
Damaged Pipe
Transition
Length of Service:
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
• /am
Time 2 7 • -,- o pm
P ne✓�
t f 4 inspector Signature
\... / ,
Obstruction
Unable to push past
feet
Number of stacks 1 Entered S.L.. at j i?
Notes
/J
•
Final Cleanout:
n
:( ) ..?
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
s
d,J
F ..
Pink Copy: SEH