2093 Marble Lane - Inspection FormCity of lingo
Residential Sanitary Sewer Service
Compliance Inspection
zk'
Date (Y?/ e)/ / /CC
Name L,vrr6E/ /c7 't' Disk#
if/4/g( 1
ND Number
House Number Z. r
Alternative Mailing Address
OwnerlOccupant Signature
For information call 651
Compliance
0/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 L r '�
Poor.PipeJoints_
Mineral Deposits
Sag /Pipe Deflection - /' °' .
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Pr opetty Ownex
r • -6 am
Time r ' s • ='J' o pm
1—Lotd EL
Street Name
1
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
Length of Service:
Yellow Copy: City of Eagan_
Record Number
•
o arty
Time ? • O pm
Phone' � '"
3
f / / �� /t
4 -- 7
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Inspection
refused
Number of stacks Entered S.L.at )i (-I1
Final Cleanout:
•
O Access to service .
lateral needed
Pink Copy: SEH
Total
f /
Note ;; ;f/ i �, _ ` r � . .
' ;. - _ ,r c`
Number
Discharged
Correctly
incorrectly
Unknown
Sump pumps
Foundation drains
---------------
"—"°
Roof drains
City of lingo
Residential Sanitary Sewer Service
Compliance Inspection
zk'
Date (Y?/ e)/ / /CC
Name L,vrr6E/ /c7 't' Disk#
if/4/g( 1
ND Number
House Number Z. r
Alternative Mailing Address
OwnerlOccupant Signature
For information call 651
Compliance
0/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 L r '�
Poor.PipeJoints_
Mineral Deposits
Sag /Pipe Deflection - /' °' .
Damaged Pipe
Transition
4" to 6 "Transition:
White Copy: Pr opetty Ownex
r • -6 am
Time r ' s • ='J' o pm
1—Lotd EL
Street Name
1
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
Length of Service:
Yellow Copy: City of Eagan_
Record Number
•
o arty
Time ? • O pm
Phone' � '"
3
f / / �� /t
4 -- 7
Inspector Signature
Obstruction
Unable to push past
feet.
No Access
O No one in
O Inspection
refused
Number of stacks Entered S.L.at )i (-I1
Final Cleanout:
•
O Access to service .
lateral needed
Pink Copy: SEH