2044 Marble Lane - Inspection FormCity of td dCl
Residential Sanitary Sewer Service
Correpliance Inspection
Date7l 1 /0
Namer''' -. - 1r_` G �C '! isk #
PID Number
House Number Street Name
A1ter'native Mailing Address
f /
For information call 65
Compliance
0 "No foundation drain connection
TO No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,b'No sump pump
Ser vice Lateral Inspection Findings Number of stacks
Roots i , a5
I / / r
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection_
Damaged Pipe
Transition
4" to 6" Transition: 4r., /C
White Copy: Property Owner
• o am
Time e__c �' oepm
Ol erlOccupbnt Signature
Nan - 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
Length of Service:
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet
Entered S.L.at
Final Cleanout:
▪ o am
Q pm
Phone _ /) _.a, ,/
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes C) Odle ¢
qty 4:Te9
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number-Discharged
Correctly
Incorrectly
-
Unknown
Sump pumps
Foundation drains
Roof drains
, -
City of td dCl
Residential Sanitary Sewer Service
Correpliance Inspection
Date7l 1 /0
Namer''' -. - 1r_` G �C '! isk #
PID Number
House Number Street Name
A1ter'native Mailing Address
f /
For information call 65
Compliance
0 "No foundation drain connection
TO No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
,b'No sump pump
Ser vice Lateral Inspection Findings Number of stacks
Roots i , a5
I / / r
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection_
Damaged Pipe
Transition
4" to 6" Transition: 4r., /C
White Copy: Property Owner
• o am
Time e__c �' oepm
Ol erlOccupbnt Signature
Nan - 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
Length of Service:
Record Number
Time
inspector Signature
Obstruction
Unable to push past
feet
Entered S.L.at
Final Cleanout:
▪ o am
Q pm
Phone _ /) _.a, ,/
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes C) Odle ¢
qty 4:Te9
Yellow Copy: City of Eagan Pink Copy: SEH