1514 Wellington Way - Inspection Form:Residential Sanitary Saver S :
co pl al c a ecti
co
ice
Date '.° 1 r7 ,_.,
Name
P1D Number
House Number
For Information call 651.470.2788
Alternate Mailir}g A res
Owner /Occupant Signe bre
Compliance
,4` No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
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
0 am
Time f s ' C; - �' pm
�
Disk tt
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
Number of stacks 2 Entered S L. at ki
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
y -}
Time
Phone
lnsp ctor Signature
Final Cleanout:
o am
o pm
("72_ 7 2-3 6 q1
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
( > C
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551
Total
Notes .
art — eY d, i-�.. --c
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
-- ---- --
Foundation Drains
--------
Roof Drains
° -----
:Residential Sanitary Saver S :
co pl al c a ecti
co
ice
Date '.° 1 r7 ,_.,
Name
P1D Number
House Number
For Information call 651.470.2788
Alternate Mailir}g A res
Owner /Occupant Signe bre
Compliance
,4` No foundation drain connection
No roof drain connection
Sump pit not connected to
sanitary sewer
o Sump Pump properly piped
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
0 am
Time f s ' C; - �' pm
�
Disk tt
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
Number of stacks 2 Entered S L. at ki
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
Unable to push past
feet
y -}
Time
Phone
lnsp ctor Signature
Final Cleanout:
o am
o pm
("72_ 7 2-3 6 q1
No Access
O No one in
o Access to service lateral
needed
O Inspection refused
( > C
Pink Copy: Benjamin Franklin Plumbing
651 -222 -1551