2089 Quartz Lane - Inspection FormCity of Fa
Residential Sanitary Sewer Service
Compliance Inspection
Date ' 1 Z 9 1 /o Time C2 :0 p pm
Name /sfi" a /7g J 44 d Disk#
PID Number
I-louse Number 2-J Street Name
Alternative Mailing Address
•
t (srL
OwnerlOccupant Signature
For information call 65 470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Non - Compliance
0
O
O
0
0
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
7CC
V
--LE
ab/ L AV
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks 1
Length of Service: ,'
Record Number
} p r --
Time 07
Obstruction
Unable to push past
feet
• 7 0
s
Phone
/ 1-
1,4pector Signature
r ,
.e
0 pm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Entered S L.. at 3 rc
Final Cleanout:/4/ / ;7 ,,-/
Notes ( / 7 2. %j . " "s ic^,/ •
r �.
r
r
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
''''9174,
Roof drains
-.--t f
City of Fa
Residential Sanitary Sewer Service
Compliance Inspection
Date ' 1 Z 9 1 /o Time C2 :0 p pm
Name /sfi" a /7g J 44 d Disk#
PID Number
I-louse Number 2-J Street Name
Alternative Mailing Address
•
t (srL
OwnerlOccupant Signature
For information call 65 470.2788
Compliance
O No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
Sump pump properly piped
O No sump pump
4" to 6 "Transition:
White Copy: Property Owner
Non - Compliance
0
O
O
0
0
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
7CC
V
--LE
ab/ L AV
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks 1
Length of Service: ,'
Record Number
} p r --
Time 07
Obstruction
Unable to push past
feet
• 7 0
s
Phone
/ 1-
1,4pector Signature
r ,
.e
0 pm
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Entered S L.. at 3 rc
Final Cleanout:/4/ / ;7 ,,-/
Notes ( / 7 2. %j . " "s ic^,/ •
r �.
r
r
Yellow Copy: City of Eagan Pink Copy: SEH