4259 Rahn Rd - Inspection Form11111
City oi Papa
• •
Residential Sanitary Sewer Service
Compliance Inspection
Om
Date 6 / Time /1( •.c}c=i pm
Name
PID Number
House Number /
Alternative Mailing Address
Compliance
Ofio foundation drain connection
K No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
R i No sump pump
White Copy: Property Owner
1
4" to 6"Transition:
/ x >.
Disk #
Set vice Lateral Inspection Findings
0
Street Name
OwnerlOccupant Signature
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
Roots
Poor PipeJoints
Mineral Deposits
Z7
Sag/Pipe Deflection
Damaged Pipe
Transition 4/AI ./.2)
/
'
,—Length of Service:
Record Number
P re-
Ia
/7
Inspector Signature
Obstruction
Unable to push past
feet
Entered S L.at
7
Notes
•
Time
o am
• _6' pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
_......_
_
Foundation drains
Roof drains
.."--
11111
City oi Papa
• •
Residential Sanitary Sewer Service
Compliance Inspection
Om
Date 6 / Time /1( •.c}c=i pm
Name
PID Number
House Number /
Alternative Mailing Address
Compliance
Ofio foundation drain connection
K No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
R i No sump pump
White Copy: Property Owner
1
4" to 6"Transition:
/ x >.
Disk #
Set vice Lateral Inspection Findings
0
Street Name
OwnerlOccupant Signature
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
Roots
Poor PipeJoints
Mineral Deposits
Z7
Sag/Pipe Deflection
Damaged Pipe
Transition 4/AI ./.2)
/
'
,—Length of Service:
Record Number
P re-
Ia
/7
Inspector Signature
Obstruction
Unable to push past
feet
Entered S L.at
7
Notes
•
Time
o am
• _6' pm
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH