4312 Jasper Dr - Inspection Formr City or 1a ji
Residential Sanitary Sewer Service
Compliance Inspection
Dates ' I ! .. i
r
Name l',.,
PID Number
•
ti
House Number Street Name
Alternative; Mailing Address'': _ .
/
For information call 451.470;2788
npliance
ci O No foundation drain connection
z
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Finings
Roots ! r jf r -
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
✓'i _ f Disk #
Damaged Pipe t
Transition 1 1 j rf l - ` 3
T 4" to 6 "Transition:
White Copy: Pt open ty Owner
r ) ll � )
.�K..i � am
Time A • ' o pm
"Ow7 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
Number of stacks
) - L . Length of Service:
Yellow Copy: City of Eagan
Phone _ f 1" -'
Record Number
Entered S.L at
•
Inspector Signature
Obstruction
Unable to push past
feet
'0 pm
No Access
O No one in
O Access to service .
lateral needed
f j
(l
O Inspection
refused
I
Final Cleanout: > -'
Pink Copy: SEH
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
Foundation drains
- '
Roof drains
r City or 1a ji
Residential Sanitary Sewer Service
Compliance Inspection
Dates ' I ! .. i
r
Name l',.,
PID Number
•
ti
House Number Street Name
Alternative; Mailing Address'': _ .
/
For information call 451.470;2788
npliance
ci O No foundation drain connection
z
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
Service Lateral Inspection Finings
Roots ! r jf r -
Poor Pipe Joints
Mineral Deposits
SaglPipe Deflection
✓'i _ f Disk #
Damaged Pipe t
Transition 1 1 j rf l - ` 3
T 4" to 6 "Transition:
White Copy: Pt open ty Owner
r ) ll � )
.�K..i � am
Time A • ' o pm
"Ow7 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
Number of stacks
) - L . Length of Service:
Yellow Copy: City of Eagan
Phone _ f 1" -'
Record Number
Entered S.L at
•
Inspector Signature
Obstruction
Unable to push past
feet
'0 pm
No Access
O No one in
O Access to service .
lateral needed
f j
(l
O Inspection
refused
I
Final Cleanout: > -'
Pink Copy: SEH