4296 Amber Dr - Inspection FormCity of to ri
Residential Sanitary Sewer Service
Compliance Inspection
o am
Date. (24' 1.�.5 o 1 c) Time • OO ,.43 ;m
Name ; //4/
4 7 + Disk #
PID Number
House Number
Alternative Mailing Address
Street Name _ .../i 'i`i'`, /De
Owner /Occupant Signature
For information call 65
Compliance
:! No foundation drain connection
j No roof drain connection
/'
O Sump pic not connected to
sanitary sewer
O Sump pump properly piped
e No sump pump
Service La era! Inspection Findings Number of stacks _ I Entered 5.L at �`
Poor PipeJoints
Mineral Deposits/lb,)(--k .� * ..
Sag /Pipe Deflection
Damaged Pipe
Transition
z
0
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
6
4" to 6" Transition: i Length of Ser vice:
White Copy: Property Owner
[�1
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Inspector Signature
• - r o am
• Pm
No Access
O No one in
f
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH
Notes
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
t
Roof drains
{ '
--`~_.... s
. _ . _ .
-- .
City of to ri
Residential Sanitary Sewer Service
Compliance Inspection
o am
Date. (24' 1.�.5 o 1 c) Time • OO ,.43 ;m
Name ; //4/
4 7 + Disk #
PID Number
House Number
Alternative Mailing Address
Street Name _ .../i 'i`i'`, /De
Owner /Occupant Signature
For information call 65
Compliance
:! No foundation drain connection
j No roof drain connection
/'
O Sump pic not connected to
sanitary sewer
O Sump pump properly piped
e No sump pump
Service La era! Inspection Findings Number of stacks _ I Entered 5.L at �`
Poor PipeJoints
Mineral Deposits/lb,)(--k .� * ..
Sag /Pipe Deflection
Damaged Pipe
Transition
z
0
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
6
4" to 6" Transition: i Length of Ser vice:
White Copy: Property Owner
[�1
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
Inspector Signature
• - r o am
• Pm
No Access
O No one in
f
Final Cleanout:
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH