2058 Copper Lane - Inspection FormVd.v 16 u 1
City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date f 1 / 1 /'
Name /),1/6"/) ,47 Disk #
PID Number
House Number
Alternative Mailing Address
For inforrriation call 651
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
R e l\lo sump pump
4" to 6 "Transition:
• Time /1 a G -0 pm
Street Name
. ;
Ownerl0ccupant Signature
Non
0
0
0
0
0
7 07d rattl—LE
- Compliance
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
White Copy: Proper ty Owner
▪ /7 fry I ,,,e2t : /f 7
Yellow Copy: City of Eagan
Record Number
Time
/1 . _5
Phone (g?)
1 t1
r�
hspectar Signature
Obstruction
Unable to push past
feet
Number of stacks Entered S. L. at �
Service Lateral Inspection Findings
Roots' 1 10
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
.e am
0 pm
w ', ,c "✓ Di
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Number.
Correctly
Discharged,_
Incorrectly Unknown
Notes
7 1rl.
C �,
Total
Sump pumps
g
Foundation drains
°__ `_ _.
Roof drains
°
Vd.v 16 u 1
City of Ea as
Residential Sanitary Sewer Service
Compliance Inspection
Date f 1 / 1 /'
Name /),1/6"/) ,47 Disk #
PID Number
House Number
Alternative Mailing Address
For inforrriation call 651
Compliance
No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
R e l\lo sump pump
4" to 6 "Transition:
• Time /1 a G -0 pm
Street Name
. ;
Ownerl0ccupant Signature
Non
0
0
0
0
0
7 07d rattl—LE
- Compliance
Clear water connections to
sanitary sewer.
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Length of Service:
White Copy: Proper ty Owner
▪ /7 fry I ,,,e2t : /f 7
Yellow Copy: City of Eagan
Record Number
Time
/1 . _5
Phone (g?)
1 t1
r�
hspectar Signature
Obstruction
Unable to push past
feet
Number of stacks Entered S. L. at �
Service Lateral Inspection Findings
Roots' 1 10
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Final Cleanout:
.e am
0 pm
w ', ,c "✓ Di
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH