2082 Bluestone Dr E - Inspection Form\J\U V/4 f
City of Ca as
Residential Sanitary Sewer Service
•
Compliance inspecti ®n
Date 1
L.
PID Number
House Number
4" to 6 "Transition:
)(
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
am
Time • pm
2 J 1
Name �. � � '��!�"�%'' "' 3�1� Disk #
Street Name
Alternative Mailing Address
/
i
OwnerlOccupant Signature
LLJ-LLJ
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
inspector Signature
For i information call 651:470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots --
PoorPipe Joints \ � � / '� (`J a /
- -. — e77:::: '''(''':'") , r ! C r =`
Mineral Deposits i .:;- ?` ; Sr " J sr --.�: ?.1 , ir - < - _ >'' _ 6.-„--,.. -`` : , -,,_
�
Sag /Pipe Deflection - F! -�"%. / )C� � 2 ° " " : 1 = `7 2, r , , f I �, f ,
Damaged Pipe i':% � ` ;! ,! -2'1 ~'- ,%- ; 1 —44-7-7 ... °' - ' .o f ,.. .-X .
Transition
Final Cleanout:
O am
• Opm
No Access
O No one in
Access to service
lateral needed
c i'o
O Insp n
refused
Pink Copy: SEH
Notes
Number
Correctly
Discharged
lncorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
\J\U V/4 f
City of Ca as
Residential Sanitary Sewer Service
•
Compliance inspecti ®n
Date 1
L.
PID Number
House Number
4" to 6 "Transition:
)(
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
White Copy: Property Owner
am
Time • pm
2 J 1
Name �. � � '��!�"�%'' "' 3�1� Disk #
Street Name
Alternative Mailing Address
/
i
OwnerlOccupant Signature
LLJ-LLJ
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
Length of Service:
Yellow Copy: City of Eagan
Record Number
Phone
Time
inspector Signature
For i information call 651:470.2788
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S.L. at
Roots --
PoorPipe Joints \ � � / '� (`J a /
- -. — e77:::: '''(''':'") , r ! C r =`
Mineral Deposits i .:;- ?` ; Sr " J sr --.�: ?.1 , ir - < - _ >'' _ 6.-„--,.. -`` : , -,,_
�
Sag /Pipe Deflection - F! -�"%. / )C� � 2 ° " " : 1 = `7 2, r , , f I �, f ,
Damaged Pipe i':% � ` ;! ,! -2'1 ~'- ,%- ; 1 —44-7-7 ... °' - ' .o f ,.. .-X .
Transition
Final Cleanout:
O am
• Opm
No Access
O No one in
Access to service
lateral needed
c i'o
O Insp n
refused
Pink Copy: SEH