2073 Quartz Lane - Inspection FormSump pumps
Foundation drains
% '
Roof drains
City of Eag,aa
Residential Sanitary Sewer Service
Compliance Inspection
Date(2 / .
r
Name
PID Number
House Number
Alternative MailingAddress
om pliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
Q p No sump pump
Service Lateral Inspection Findi
Roots
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition '--
4" to 6" Transition:
White Copy: Property Owner
Time
•;' / ,,": /4 Disk #
it
Street Name
Owner /Occupant Signature
/
am
pm
1
Length of Service:
Number. Discharged
Total Correctly Incorrectly
Unknown
Yellow Copy: City of Eagan
Record Number
Notes
Jr �. ro am
Time a 1 O 1 pm
Phone _ .� ,
Obstruction
Inspector Signature
For information call 65 1.:470.2788
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
gs Nyrplr of stacks, i Entered 5. L. at
Unable to push past
feet
1/
/ z - Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH