2065 Copper Lane - Inspection Form41*
• Git of a ii
y �
Residential Sanitary Sewer Service
Compliance Inspection
• ^ O am
Date l , 1 / Time // • SO Q .- pr ,
Name ? iJ / 2/ 2 Disk #
PID Number
House Number 76t<S"
Alternative Mailing Address
v
L wnerlOccupant Signature
For information call 651.470.2788
i ipliance
dNO foundation drain connection
d / No roof drain connection
6 Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
p
Service Lateral Inspection Findings
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
4" to 6" Transition:
White Copy: Property Owner
)
Street Name fc e
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
Damaged Pipe
Transition L 1 r, ,,,
Length of Service: /7f)-
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
• O am
• p'm
Phoe
inspector Signature
No Access
O No one in
O Inspection
refused
Number of stacks ( Entered S L at 3
Final Cleanout:
O Access to service
lateral needed
Pink Copy: SEH
Number Discharged
Unknown
Notes
0 (.0C1‘_ w >. r r
J ) bA
Total
Correctly
Incorrectly
Sump pumps
.__
_
___ ..
Foundation drains
Roof drains
41*
• Git of a ii
y �
Residential Sanitary Sewer Service
Compliance Inspection
• ^ O am
Date l , 1 / Time // • SO Q .- pr ,
Name ? iJ / 2/ 2 Disk #
PID Number
House Number 76t<S"
Alternative Mailing Address
v
L wnerlOccupant Signature
For information call 651.470.2788
i ipliance
dNO foundation drain connection
d / No roof drain connection
6 Sump pit not connected to
sanitary sewer
0 Sump pump properly piped
No sump pump
p
Service Lateral Inspection Findings
Roots
PoorPipeJoints
Mineral Deposits
Sag /Pipe Deflection
4" to 6" Transition:
White Copy: Property Owner
)
Street Name fc e
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
Damaged Pipe
Transition L 1 r, ,,,
Length of Service: /7f)-
Yellow Copy: City of Eagan
Record Number
Time
Obstruction
Unable to push past
feet
• O am
• p'm
Phoe
inspector Signature
No Access
O No one in
O Inspection
refused
Number of stacks ( Entered S L at 3
Final Cleanout:
O Access to service
lateral needed
Pink Copy: SEH