1518 Wellington Way - Inspection FormResidential Sanitary Sewer Service
Compliance Inspection
Ea
Date Q1 j�'1
Name
PID Number
Transition
:rn
House Number j t
Alternate Mailing Address
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
e rte C
Compliance
• No foundation drain connection
O No roof drain connection
o r Sump pit not connected to
sanitary sewer
O Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
0
4" to 6" Transition:
White Copy: Property Owner
Time C =3tj
7 .c
,1
" a%
Disk #
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
o ya
O pm
Street Name
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
� l�
Unable to push past
feet
1 •'4-
Time
3 3 C.,
Inspector Signature
Number of stacks I Entered S L at
Final Cleanout:
O am
o pm
Phone LAS ! _� �1 ' S 7'7 q
For Information call 651.470.2788
No Access
o No one in
D Access to service lateral
needed
o Inspection refused
C i
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551
Total
N otes
q .,a
C- c CS.= s5
O .,
C 1
3
r
/ 5-f c t,
t
Number
Discharged
Correctly
Incorrectly
Unknown
Sump Pumps
Foundation Drains
Roof Drains
Residential Sanitary Sewer Service
Compliance Inspection
Ea
Date Q1 j�'1
Name
PID Number
Transition
:rn
House Number j t
Alternate Mailing Address
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
e rte C
Compliance
• No foundation drain connection
O No roof drain connection
o r Sump pit not connected to
sanitary sewer
O Sump Pump properly piped
No sump pump
Service Lateral Inspection Findings
0
4" to 6" Transition:
White Copy: Property Owner
Time C =3tj
7 .c
,1
" a%
Disk #
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
o ya
O pm
Street Name
Length of Service:
Yellow Copy: City of Eagan
Record Number
Obstruction
� l�
Unable to push past
feet
1 •'4-
Time
3 3 C.,
Inspector Signature
Number of stacks I Entered S L at
Final Cleanout:
O am
o pm
Phone LAS ! _� �1 ' S 7'7 q
For Information call 651.470.2788
No Access
o No one in
D Access to service lateral
needed
o Inspection refused
C i
Pink Copy: Benjamin Franklin Plumbing
651- 222 -1551