4261 Diamond Dr - Inspection FormrCity al'Ea a
Residential Sanitary Sewer Service
Compliance Inspection
7 -
Date 1 _/ /(- 2
Nam' AA 9
PO Number
House Number
Alternative Mailing Address. —"�"
(2L/
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
( No sump pump
Disk #
/Owner /Occupant Signature
For information call 651.470.2788
Co pliance
No foundation drain connection
No roof drain connection
Service La eral Ins ec ion g
Findin s
Roots /. / 1
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
/'; • r ` I
4" to 6" Transition:
White Copy: Property Owner
• ?.-<J am
Time f • � pm
Street Name
/ ,)/ 1
1
Phone
1
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
Number of stacks !
•
Record Number
Length of Service: c � ! -
Notes
Time
Obstruction
Unable to push past
feet
• ✓^
•
Inspector Signature
am
opm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L,at
l
.
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
'1
Foundation drains
V
Roof drains
rCity al'Ea a
Residential Sanitary Sewer Service
Compliance Inspection
7 -
Date 1 _/ /(- 2
Nam' AA 9
PO Number
House Number
Alternative Mailing Address. —"�"
(2L/
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
( No sump pump
Disk #
/Owner /Occupant Signature
For information call 651.470.2788
Co pliance
No foundation drain connection
No roof drain connection
Service La eral Ins ec ion g
Findin s
Roots /. / 1
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
/'; • r ` I
4" to 6" Transition:
White Copy: Property Owner
• ?.-<J am
Time f • � pm
Street Name
/ ,)/ 1
1
Phone
1
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
Number of stacks !
•
Record Number
Length of Service: c � ! -
Notes
Time
Obstruction
Unable to push past
feet
• ✓^
•
Inspector Signature
am
opm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Entered S L,at
l
.
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH