4241 Jasper Dr - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Date
Name
/( Time
/ 3 _ X9 1 Disk #
PID Number
Alternative Mailing Address
Owr; r /Occupant Signature
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
am
pm
Non - Compliance
Mi D
House Number �! Street Name I )r
Phone f - < 2
For information :call 65
Service L to tspec o ,Fin + . Number of stacks _
Roots s� , 7
1
Record Number
Obstruction
Inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
am
•
Time • pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused'
Entered 5 ` r
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
s
;`. White Copy: Proper ty Owner
/
f .o
Length of Service:
Yellow Copy: City of Eagan
i/J
Final Cleanout:
Pink Copy: SEFi
Number
Correctly
Discharged
Notes
Total
Incorrectly
Unknown
Sump pumps
i
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Compliance Inspection
Date
Name
/( Time
/ 3 _ X9 1 Disk #
PID Number
Alternative Mailing Address
Owr; r /Occupant Signature
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
am
pm
Non - Compliance
Mi D
House Number �! Street Name I )r
Phone f - < 2
For information :call 65
Service L to tspec o ,Fin + . Number of stacks _
Roots s� , 7
1
Record Number
Obstruction
Inspector Signature
O Clear water connections to Unable to push past
sanitary sewer feet
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
am
•
Time • pm
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused'
Entered 5 ` r
Poor Pipe joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
s
;`. White Copy: Proper ty Owner
/
f .o
Length of Service:
Yellow Copy: City of Eagan
i/J
Final Cleanout:
Pink Copy: SEFi