4356 Sandstone Dr - Inspection FormCity of Flay]
Residential Sanitary Sewer Service
Compliance inspection
}} f') /241( am
Date 1 Time • pm
Name r !
),J
PID Number
House Number !-- 47,
Alternative MailingAddress 4 -4. f1l4 ' I4Z
i
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Latera I s ection Findings Number of star ys
Roots : !� � 7 r a ,
/
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
4" to 6 "Transition:
White Copy: Property Owner
Disk #
";-"Street Name
ci wner /Occupant Signature)
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
/2
l
Record Number
445
Q, am
Time _f Y ` pm
Phone mac 7 —
(r_.-L'---6.3/t97.7,._. . 7
2
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered St at
Damaged Pipe
Transition
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
;? Final Cleanout:
Pink Copy: SEH
Total
Notes
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
' r/ b
f
1
Foundation drains
! �.
Roof drains
( �
City of Flay]
Residential Sanitary Sewer Service
Compliance inspection
}} f') /241( am
Date 1 Time • pm
Name r !
),J
PID Number
House Number !-- 47,
Alternative MailingAddress 4 -4. f1l4 ' I4Z
i
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Latera I s ection Findings Number of star ys
Roots : !� � 7 r a ,
/
Poor PipeJoints
Mineral Deposits
Sag /Pipe Deflection
4" to 6 "Transition:
White Copy: Property Owner
Disk #
";-"Street Name
ci wner /Occupant Signature)
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
/2
l
Record Number
445
Q, am
Time _f Y ` pm
Phone mac 7 —
(r_.-L'---6.3/t97.7,._. . 7
2
Inspector Signature
For information call 651.470.2788
Obstruction
Unable to push past
feet
Entered St at
Damaged Pipe
Transition
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
;? Final Cleanout:
Pink Copy: SEH
\N D (' 0 11;1z
Residential Sanitary Sewer Servile
Compliance Inspection
Date -/ /-
Name
PID Number
House Number
l
Alternative Mailing Address
Owner /Occupant Signature
For information call :65 .
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
• -, -G/5'm
C • ✓ o pm
Ds # JJ — LLJ — L �—J
•
/ /1( ; Street Name _
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
Record Number
Time
/ 1 /
.% /7/Inspector Signatur
Obstruction
Unable to push past
feet.
Service Lateral Inspection Findings Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Proper ty Owner
Length of Service:
Number Discharged
pumps
Foundation drains
Roof drains
Total
Correctly Incorrectly Unknown
Yellow Copy: City of Eagan
Notes
� f' c
rz
Final Cleanout:
o am
•
• o pm
Phone' ��. t''r�
NO Access
r
No one in
O Access to service .
lateral needed
O Inspection
refused
Pink Copy: SEH