2066 Shale Lane - Inspection FormSump pumps
Foundation drains
Roof drains
4 l a
City off' Eoloo
Residen�iai an Sewer Service
Compliance Inspection
Date 0 j / 0 7 / f
Name —1,1.4./7 ( f bi sk#
� C
e6./ ,r
PID Number
House Number 0
Alternative Mailing Address
I
2/
Compliance
....- No foundation drain connection
No roof drain connection
0 Sump pit not connected to
sanitary sewer
Sump pump properly piped
No sump pump
Service Lateral Inspection Findings
Roo
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
4" to 6" Transitiony/
White Copy: Property Owner
�. • S
Time C 7 • c ti o apm m
0
/ /
4 f 71 2 r__ J-
Ownerl0ccupant Sigii ture
Street Name
4,
1
For information call 651.470, 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
Damaged Pipe
Transition
Number of stacks t Entered S.L at
Length of Service:
Number Discharged
Total Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
C�!
Record Number ° J7
0 2 • �1 am
Time • 0 P
Phon
6,7 , 'f7,
/ inspector Signature
Obstruction
Unable to push past
feet
Final Cleanout:
No Access
O No one in
Notes
- 1 L- r
O Access to service
lateral needed
O Inspection
refused
Pink Copy: SEH