4272 Jasper Dr - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date
i
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
or pliance
No fdundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
f No sump pump
Service Laterins ; Findings
Roots ; /II ,
f' 1
4" to 6 "Transition: 4
White Copy: Property Owner
•_ am
Time • pm
Name , n 7 ' . ) 1 7 Disk #
PID Number
/
House Number Street Name
Alternative Mailing Address
X 77
fV
Owner /Occupant Signature
Number of stacks
Length of Service:
C
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
1
Record Number
Phone
Inspector Signature
For information call 65 !
f' " •
Obstruction
Unable to push past
feet
Entered S L at
Notes
• r} "?{ i1 am
Time C' "..5 • o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
I
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Nursber
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
/ 'j
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date
i
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
or pliance
No fdundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
f No sump pump
Service Laterins ; Findings
Roots ; /II ,
f' 1
4" to 6 "Transition: 4
White Copy: Property Owner
•_ am
Time • pm
Name , n 7 ' . ) 1 7 Disk #
PID Number
/
House Number Street Name
Alternative Mailing Address
X 77
fV
Owner /Occupant Signature
Number of stacks
Length of Service:
C
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
1
Record Number
Phone
Inspector Signature
For information call 65 !
f' " •
Obstruction
Unable to push past
feet
Entered S L at
Notes
• r} "?{ i1 am
Time C' "..5 • o pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
I
Final Cleanout:
Yellow Copy: City of Eagan Pink Copy: SEH
