2146 Marble Lane - Inspection FormCity 1 Ea o
Residential Sanitary Sewer Service
Compliance inspection
Date e / / /
Name if it /= / /1 7//f
PO Number
House Number
Alternative MailingAddress
Compliance
b ^ No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
of No sump pump
4" to b "Transition:
White Copy: Property Owner
T ime• /G ! .,5pm
Disk #
L d - Li2 i
Record Number
"° am
J j •
Time / r • ._"' r s pm
e //. Street Name / 0r
Owner /Occupant Signature
Service Later al Inspection Findings
Roots / _J
/ r
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
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
b
Number of stacks 1
Length of Service:
Phone • ,
L � P
▪ /inspector Signature
For information call 65
Obstruction
Unable to push past
feet
Entered S L at
fi
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes Lilo
►`'(7A/ 4.)
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
Discharged
incorrectly
Unknown
Total
Sump pumps-
/..-- .
.—... -----
Foundation drains
_ - `
" _
Roof drains
r' 1
_ .__ ______
..______ _ __
City 1 Ea o
Residential Sanitary Sewer Service
Compliance inspection
Date e / / /
Name if it /= / /1 7//f
PO Number
House Number
Alternative MailingAddress
Compliance
b ^ No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
of No sump pump
4" to b "Transition:
White Copy: Property Owner
T ime• /G ! .,5pm
Disk #
L d - Li2 i
Record Number
"° am
J j •
Time / r • ._"' r s pm
e //. Street Name / 0r
Owner /Occupant Signature
Service Later al Inspection Findings
Roots / _J
/ r
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
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
b
Number of stacks 1
Length of Service:
Phone • ,
L � P
▪ /inspector Signature
For information call 65
Obstruction
Unable to push past
feet
Entered S L at
fi
Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Notes Lilo
►`'(7A/ 4.)
Yellow Copy: City of Eagan Pink Copy: SEH