2081 Quartz Lane - Inspection FormCity o '; bpi
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
-'
House Number
Alternative Mailing Address
Owner /Occupant .Signature
For information call 651
Compliance
O No foundation drain connection
•.
Time •
_ ' -rye
�,/ / Disk#
No roof drain connection
/\
O Sump pic not connected to
sanitary sewer
O, Sump pump properly piped
No sump pump
Service Lateral Inspection Fip
/
Roots �-°t %
Poor Pipe joints
Mineral Deposits
.e/
4" to 6" Transition: j
White Copy: Property Owner
Street Name
am
Pm
Sag /Pipe Deflection
Damaged Pipe
Transition t 1 ' ' �- ' " " """"`..� r- • - -• - � �.
,--
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
gs Number of stacks _.
2 2 : - .;
Length of Service:
Yellow Copy: City of Eagan
Phone f; 27
Record Number
Entered S.L. at f1
Inspector Signature
Obstruction
Unable to push past
feet
p
Pm
No No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
i
} Final Cleanout: r . i i`'�
Pink Copy: SEH
Number
Correctly
Note
Discharged j -- , c-
., }�� -z
�
Total
Incorrectly Unknown
(---''' /� / T { ' "` - I ` '`
,' t .
- ...T - 7' /� f / ' n r f.uw., J)J =� i
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Sump pumps
Foundation drains
Roof drains
c .
City o '; bpi
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
PID Number
-'
House Number
Alternative Mailing Address
Owner /Occupant .Signature
For information call 651
Compliance
O No foundation drain connection
•.
Time •
_ ' -rye
�,/ / Disk#
No roof drain connection
/\
O Sump pic not connected to
sanitary sewer
O, Sump pump properly piped
No sump pump
Service Lateral Inspection Fip
/
Roots �-°t %
Poor Pipe joints
Mineral Deposits
.e/
4" to 6" Transition: j
White Copy: Property Owner
Street Name
am
Pm
Sag /Pipe Deflection
Damaged Pipe
Transition t 1 ' ' �- ' " " """"`..� r- • - -• - � �.
,--
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
gs Number of stacks _.
2 2 : - .;
Length of Service:
Yellow Copy: City of Eagan
Phone f; 27
Record Number
Entered S.L. at f1
Inspector Signature
Obstruction
Unable to push past
feet
p
Pm
No No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
i
} Final Cleanout: r . i i`'�
Pink Copy: SEH