2073 Marble Lane - Inspection FormCity of pia au
Residential Sanitary Sewer Service
Compliance Inspection
•. }f am
Date/ 1) Time -� pm
Name ) 1 5 Ld -e e Disk #
1
. K1PID Number
qC °� ouse Num
\ \ Alt ative MailingAd
' { c- C' - C.-. -& / l r - -- _ -` ...uz--
) ,-. Ormerl0ccupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6 "Transition:
White Copy: Property Owner
Street Name
Service Lateral Inspection Findings il umber of stacks
Roots �]f-S rf - 1 y e f �
i
Damaged Pipe
L 1 J �'? ()
Length of Service:
t
Record Number
r �- Phone /' f
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
ET }11�i�
Time f ..--/ . ro pm
Entere S L.at
Inspector Signature
For information call 65 1 470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
s
City of pia au
Residential Sanitary Sewer Service
Compliance Inspection
•. }f am
Date/ 1) Time -� pm
Name ) 1 5 Ld -e e Disk #
1
. K1PID Number
qC °� ouse Num
\ \ Alt ative MailingAd
' { c- C' - C.-. -& / l r - -- _ -` ...uz--
) ,-. Ormerl0ccupant Signature
Compliance
0 No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6 "Transition:
White Copy: Property Owner
Street Name
Service Lateral Inspection Findings il umber of stacks
Roots �]f-S rf - 1 y e f �
i
Damaged Pipe
L 1 J �'? ()
Length of Service:
t
Record Number
r �- Phone /' f
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
ET }11�i�
Time f ..--/ . ro pm
Entere S L.at
Inspector Signature
For information call 65 1 470.2788
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes
Yellow Copy: City of Eagan Pink Copy: SEH