4313 Amber Dr - Inspection Form• , ti
City of. Papa
Residential Sanitary Sewer Serv1ce
Compliance Inspection
PID Number
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
t 0 Sump pump properly piped
No sump pump
Service Lateral inspection Findings
Roots
Poor Pipef oints
4" to 6" Transition:
n
Date 7 j / / Time
om
Name /, 7 . - ' 1 / Disk #
House Number / Street Name
�j ) p
• / 0 pm
Alternative Address
lam.
Owner /0 cuparr/Signature
For information calf 65 L470.2788
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
Number of stacks
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
1
White Copy: Property Owner
Record Number
r7 • s�
Time �; • •
Phone I .:w
Inspector Signature
Obstruction
Unable to push past
feet
Entered S L.at 777-
U
J21_
JJ._
Length of Service: - Final Cleanout:
otep
/
)
i r
)
15 f
Q am
!t7 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f
Yellow Copy: City of Eagan t Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
/
r�
Roof drains
• , ti
City of. Papa
Residential Sanitary Sewer Serv1ce
Compliance Inspection
PID Number
Compliance
O No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
t 0 Sump pump properly piped
No sump pump
Service Lateral inspection Findings
Roots
Poor Pipef oints
4" to 6" Transition:
n
Date 7 j / / Time
om
Name /, 7 . - ' 1 / Disk #
House Number / Street Name
�j ) p
• / 0 pm
Alternative Address
lam.
Owner /0 cuparr/Signature
For information calf 65 L470.2788
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
Number of stacks
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
1
White Copy: Property Owner
Record Number
r7 • s�
Time �; • •
Phone I .:w
Inspector Signature
Obstruction
Unable to push past
feet
Entered S L.at 777-
U
J21_
JJ._
Length of Service: - Final Cleanout:
otep
/
)
i r
)
15 f
Q am
!t7 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
f
Yellow Copy: City of Eagan t Pink Copy: SEH