2048 Quartz Lane - Inspection FormCity of 1 a as
Residential Sanitary Sewer . Service
Compliance Inspection
Date 7
�.�� .:
Name �. �"'�lf/ p Disk # 1
HD Number.
House Number
Alternative Mailing Address
/ / / /J /� .'
Owned() e pant 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
7 Street Name , ,4
2
Service Lateral inspection Findings
4" to 6" Transition:
White Copy: Property Owner
• ;�
Time d am
• _5 G o p
Non - Compliance
0
0
0
0
0
-Lti
1
r
Record Number
Time
Phone
//Ary
'inspector Signature
• o am
• o pm
For information call 651.470.2788
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Obstruction
Unable to push past
feet
Notes .,.a 4/o
t. 2
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number
Discharged
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
City of 1 a as
Residential Sanitary Sewer . Service
Compliance Inspection
Date 7
�.�� .:
Name �. �"'�lf/ p Disk # 1
HD Number.
House Number
Alternative Mailing Address
/ / / /J /� .'
Owned() e pant 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
7 Street Name , ,4
2
Service Lateral inspection Findings
4" to 6" Transition:
White Copy: Property Owner
• ;�
Time d am
• _5 G o p
Non - Compliance
0
0
0
0
0
-Lti
1
r
Record Number
Time
Phone
//Ary
'inspector Signature
• o am
• o pm
For information call 651.470.2788
Clear water connections to
sanitary sewer
Service lateral defects
Defective manholes
Sump pump connected to sanitary
sewer
Flexible sump pump piping
Number of stacks Entered S L at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
Length of Service:
Obstruction
Unable to push past
feet
Notes .,.a 4/o
t. 2
Final Cleanout:
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
Yellow Copy: City of Eagan Pink Copy: SEH