2094 Quartz Lane - Inspection FormV\i/U VVV)At
City ollag,au
Residential :Sanity r Sewer Service
Compliance inspection
Date (A/ ° / /c✓ Time • * ` pm
Name /) !f /f1ior9aJf W j Disk#
Alternative Mailing Address
Compliance
O No foundation drain connection
0 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b "Transition: if
Owner /Occupant Signature
Cal 7f° . - Length of Service:
Non- Compliance
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
Number of stacks 1 Entered S L at
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
• 7o
Time -3 • c
PID Number - 9
House Number Street Name _ i/ ,
Phone a 7j
Inspector Signature
/ /
For information call 651:470.2788
Obstruction
Unable to push past
feet.
No Access
O No one in
Final Cleanout:
o am
pm
O Access to service
lateral needed
O Inspection
r efused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
t otes — /
(2- 7,.rL/ f
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
r
%
'
Total
Sump pump
--
Foundation drains
Roof drains
- __..
V\i/U VVV)At
City ollag,au
Residential :Sanity r Sewer Service
Compliance inspection
Date (A/ ° / /c✓ Time • * ` pm
Name /) !f /f1ior9aJf W j Disk#
Alternative Mailing Address
Compliance
O No foundation drain connection
0 No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
Service Lateral Inspection Findings
4" to b "Transition: if
Owner /Occupant Signature
Cal 7f° . - Length of Service:
Non- Compliance
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
Number of stacks 1 Entered S L at
White Copy: Property Owner
Yellow Copy: City of Eagan
Record Number
• 7o
Time -3 • c
PID Number - 9
House Number Street Name _ i/ ,
Phone a 7j
Inspector Signature
/ /
For information call 651:470.2788
Obstruction
Unable to push past
feet.
No Access
O No one in
Final Cleanout:
o am
pm
O Access to service
lateral needed
O Inspection
r efused
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
t otes — /
(2- 7,.rL/ f
Pink Copy: SEH