2042 Shale Lane - Inspection FormN otes
Number
Correctly
Discharged
Total
Incorrectly
Unknov+rn
Sump pumps
, -----
____
.._ __.-
. .
Foundation drains
-
--
— _ _ __.
Roof drains
__A_
f
City of hh ]
R esidential Sanitary Sewer Service
Compliance Inspection
Date 0/ / /oe
r ` { 4 - (:) /r r ' l Disk #
Name r
Alternative MailingAddress
/ rs E
Owner /Occupant Signature
Compliance
IV, No foundation drain connection
No roof drain connection
O Sump pit not connected co
sanitary sewer
O Sump pump properly piped
▪ No sump pump
Mineral Deposits
/
4" to 6 "Transition:
White Copy: Property Owner
• Time • y ' p pm
Length of Service:
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
Yellow Copy: City of Eagan
Record Number
J
Time
PID Number
(
House Number 4 `� / Street Name _ er
Phone ./ j �, �
/ f
)
�r J
For information call 651.470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S L at J 1
�� 4 ti
Roots _"Z , C7r 5 j 41, f,
( r J p
Poor Pipe Joints
Sag /Pipe Deflection
Damaged Pipe
.. • " • Transition � � /n. / ��� C tom :. / ._
inspector Signature
Final Cleanout:
• u a m
• 0 pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
O
Pink Copy: SEH