2031 Shale Lane - Inspection FormCity of Ea aJ
Residential Sanitary Sewer Service
Compliance Inspection
Datef)71 ( 1 /C
Name (4 Disk #
PID Number
6 '/ S treet Name i Z- ,"
House Number _
Alternative Mailing Address
4" to 6 "Transition:
White Copy: Property Owner
Ownerl0ccupant Signature
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
•
Service Lateral Inspection Findings
Roots 6. r-
Poor Pipe joints
Time f ; Pry
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number of stacks
Length of Service:
Record Number
f 4
f
Inspector Signature
Obstruction
Unable to push past
feet
Entered S L at _
Notes 77 vi
MA
/
0:
r
Phone _ (,C' €/v
No Access
O No one in
Final Cleanout:
O Access to service .
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incor'r'ectly
Unknown
Sump pumps'
,�
-�
Foundation drains
--
Roof drains
''
-
-
-
City of Ea aJ
Residential Sanitary Sewer Service
Compliance Inspection
Datef)71 ( 1 /C
Name (4 Disk #
PID Number
6 '/ S treet Name i Z- ,"
House Number _
Alternative Mailing Address
4" to 6 "Transition:
White Copy: Property Owner
Ownerl0ccupant Signature
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
•
Service Lateral Inspection Findings
Roots 6. r-
Poor Pipe joints
Time f ; Pry
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
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Number of stacks
Length of Service:
Record Number
f 4
f
Inspector Signature
Obstruction
Unable to push past
feet
Entered S L at _
Notes 77 vi
MA
/
0:
r
Phone _ (,C' €/v
No Access
O No one in
Final Cleanout:
O Access to service .
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH