2082 Quartz Lane - Inspection Formr City lli' Ian
Residential, Sanitary Sewer Service
Compliance inspection
Dat l ' ('
Name T t
PID Number
House Number Street Name _ l / / /l2
Poor Pipe joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
(vnerlOccupant Signature
Compliance
qi 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 Later51 InsWection Findings
Roots . :% 44-
I • am
Time 2S • pm
Disk #
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
SaglPipe Deflection
Damaged Pipe
'Tr'ansition
Yellow Copy: City of Eagan
Record Number
Time •
Alternative Mailing Address . ... Phone /_ - -) i
inspector Signature
For information call 45L470.2788
Obstruction
Unable to push past
feet
am
0 pm
-4 7/ )
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L. at
[- •' " 1 ,
Length of Service: !D / 1 Final Cleanout: '' s^-, c:
Pink Copy: SEH
Number
Correctly
Discharged
N otes
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
r City lli' Ian
Residential, Sanitary Sewer Service
Compliance inspection
Dat l ' ('
Name T t
PID Number
House Number Street Name _ l / / /l2
Poor Pipe joints
Mineral Deposits
4" to 6" Transition:
White Copy: Property Owner
(vnerlOccupant Signature
Compliance
qi 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 Later51 InsWection Findings
Roots . :% 44-
I • am
Time 2S • pm
Disk #
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
SaglPipe Deflection
Damaged Pipe
'Tr'ansition
Yellow Copy: City of Eagan
Record Number
Time •
Alternative Mailing Address . ... Phone /_ - -) i
inspector Signature
For information call 45L470.2788
Obstruction
Unable to push past
feet
am
0 pm
-4 7/ )
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Number of stacks Entered S L. at
[- •' " 1 ,
Length of Service: !D / 1 Final Cleanout: '' s^-, c:
Pink Copy: SEH