2078 Diffley Rd - Inspection FormCity of Eapii
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
RID Number
House Number
f�
•
•
Alternative Mailing Address
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
3 � i
i'7�P . 1 Disk #
Service Lateral Inspection Findings
Roots _
j J /
Poor Pipe Joints ?
Street Name
1
wner{ Ee pan Si ature
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 Entered S.L.
Length of Service:
Yellow Copy: City of Eagan
Record Number
i
j
� ® _ am
Time ® p pm
Obstruction
Unable to push past
feet.
Phone e ': 1. ..� "--.
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH
Number.
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
, ))
Foundation drains
-
f
Roof drains
(
Gad .� l 74,4)
City of Eapii
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
RID Number
House Number
f�
•
•
Alternative Mailing Address
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time
3 � i
i'7�P . 1 Disk #
Service Lateral Inspection Findings
Roots _
j J /
Poor Pipe Joints ?
Street Name
1
wner{ Ee pan Si ature
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 Entered S.L.
Length of Service:
Yellow Copy: City of Eagan
Record Number
i
j
� ® _ am
Time ® p pm
Obstruction
Unable to push past
feet.
Phone e ': 1. ..� "--.
Inspector Signature
For information call 651.470.2788
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Final Cleanout:
Pink Copy: SEH