2054 Shale Lane - Inspection Form4 1111. City of Eaftao
Residential Sanitary Sewer Service
Compliance Inspection
Date 071 E 7 / /c,
Name Krell:77 67(7,4://4 Disk #
PID Number
House Number
e'6f
Alternative Mailing Address
Compliance
(6 No foundation drain connection
l e No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
i lgrNo sump pump
Service Lateral Inspection Findings
Roots • -$ 7 $
4" to 6" Transition: /417
White Copy: Property Owner
9 am
Time /f : r- 7),"
Pm
Street Name
Owner/05e, ant Signature
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Y
-FE- [;I 1J
Record Number
F
1 hone
Non
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
Poor PipeJoints
(— Length of Service:
(
Yellow Copy: City of Eagan.
Time • (LC- Fpm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Number of stacks Entered S L at , -- 191 -
Final Cleanout:
Pink Copy: SEH
Nurnber
Correctly
Discharge.d -
Incorrectly Unknown
N 4 fi 71 1,
• otes c
W /.7/
F LA r,--67
Total
Sump pumps
Foundation drains
Roof drains
_
4 1111. City of Eaftao
Residential Sanitary Sewer Service
Compliance Inspection
Date 071 E 7 / /c,
Name Krell:77 67(7,4://4 Disk #
PID Number
House Number
e'6f
Alternative Mailing Address
Compliance
(6 No foundation drain connection
l e No roof drain connection
O Sump pit not connected to
sanitar y sewer
O Sump pump properly piped
i lgrNo sump pump
Service Lateral Inspection Findings
Roots • -$ 7 $
4" to 6" Transition: /417
White Copy: Property Owner
9 am
Time /f : r- 7),"
Pm
Street Name
Owner/05e, ant Signature
Mineral Deposits
Sag/Pipe Deflection
Damaged Pipe
Transition
Y
-FE- [;I 1J
Record Number
F
1 hone
Non
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
Poor PipeJoints
(— Length of Service:
(
Yellow Copy: City of Eagan.
Time • (LC- Fpm
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
No Access
O No one in
O Access to service
lateral needed
O Inspection
r efused
Number of stacks Entered S L at , -- 191 -
Final Cleanout:
Pink Copy: SEH