2110 Marble Lane - Inspection FormCity of
Residential Sanitary Sewer Service
Compliance Inspection
Date C2 71 0 1 ./Ci
Name lei. W ---- 1 L. 2
PID Number
House Number /C Street Name
Alternative Mailing Address
White Copy. Property Owner
Time /0 odo Opm
Disk #
Owner /Occupan[ Signature
Compliance
-No foundation drain connection
)-'No roof drain connection
i„O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
A O / No sump pump
Service Lateral Insp
Roots ,5
a ction Findings
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection_
Damaged Pipe
Transition Lt t� ( um I
kLdi-
Plon-CompliancC
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
0
Rho _ � '1 > �.. /
f /
//inspector Signature
For information call 651.470.2788
4" to 6"Transition: r .�° Length of Service:
Record Number
Q
Time }
Obstruction
Unable to push past
feet
Number of stacks _ 1 Entered S L. at G,. 7k? / ( u
£d - P <% /& :_
am
�!. o pal
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
D otes rciwk
NW,
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly
Unknown
Total
Sump pumps
f —r
- ------
Foundation drains
'-'
Roof drains
__,_
_._ _ .--- _._e________-__..
City of
Residential Sanitary Sewer Service
Compliance Inspection
Date C2 71 0 1 ./Ci
Name lei. W ---- 1 L. 2
PID Number
House Number /C Street Name
Alternative Mailing Address
White Copy. Property Owner
Time /0 odo Opm
Disk #
Owner /Occupan[ Signature
Compliance
-No foundation drain connection
)-'No roof drain connection
i„O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
A O / No sump pump
Service Lateral Insp
Roots ,5
a ction Findings
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection_
Damaged Pipe
Transition Lt t� ( um I
kLdi-
Plon-CompliancC
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
0
Rho _ � '1 > �.. /
f /
//inspector Signature
For information call 651.470.2788
4" to 6"Transition: r .�° Length of Service:
Record Number
Q
Time }
Obstruction
Unable to push past
feet
Number of stacks _ 1 Entered S L. at G,. 7k? / ( u
£d - P <% /& :_
am
�!. o pal
No Access
O No one in
O Access to service .
lateral needed
O Inspection
refused
Final Cleanout:
D otes rciwk
NW,
Yellow Copy: City of Eagan Pink Copy: SEH