1511 Wellington Way - Inspection Formeskc ent tali Sanitary Sewer service
compliance inspe tioi
Date / 2 if
Name I
PID Number
House Number 1 i
Compliance
Q 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
Service Lateral Inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
4" to 6" Transition:
White Copy: Property Owner
Time 2
t �
1 1
€ i. �) �V �•�
' Owner /Occupant Signature
Disk #
0 am
: 3 d,/ p
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
Street Name
For Information call 651.470.2788
Alternate Mailing Address
/,';
Number of stacks
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
Time
(7 • V/
Phone ( f (DC1 9 i
inlector Signature
Entered S L at
t i
No Access
o No one in
o Access to service lateral
needed
o Inspection refused
Final .Cleanout:
o am
o pm
r ^y
Number Discharged
Sump Pumps
Foundation Drains
Roof Drains
Total
Correctly Incorrectly Unknown
Notes
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551