2027 Shale Lane - Inspection Formv" HO%
City .81' Ea ii
Residential Sanitary Sewer Service
Compliance Inspection
Date/..- /
Name -
PID Number
House Number i` / Street Name
Alternative Mailing Address
1
Compliance
Owner /Occupant Signature
No foundation drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
No roof drain connection
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy: Proper ty Owner
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
'Transition
Yellow Copy: City of Eagan
For information call 651:= .470.2788
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 .mil Entered S L. at
5
Length of Service: -
Record Number
Obstruction
Unable to push past
feet
T ime 73 •
Phone
inspector Signature
7
amore'= d
o, am
pm
I
No Access
O No one in
O Access to service .
lateral needed
O inspection
r efused
Final Cleanout:
Pink Copy: SEH
Number
Corr ectly
Discharged
Incorrectly Unknown
Total
Sump pumps
i'
Foundation drains
Roof drains
v" HO%
City .81' Ea ii
Residential Sanitary Sewer Service
Compliance Inspection
Date/..- /
Name -
PID Number
House Number i` / Street Name
Alternative Mailing Address
1
Compliance
Owner /Occupant Signature
No foundation drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
No roof drain connection
Service Lateral Inspection Findings
Roots
4" to 6" Transition:
White Copy: Proper ty Owner
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
'Transition
Yellow Copy: City of Eagan
For information call 651:= .470.2788
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 .mil Entered S L. at
5
Length of Service: -
Record Number
Obstruction
Unable to push past
feet
T ime 73 •
Phone
inspector Signature
7
amore'= d
o, am
pm
I
No Access
O No one in
O Access to service .
lateral needed
O inspection
r efused
Final Cleanout:
Pink Copy: SEH