4195 Topaz Dr - Inspection FormResidential Sanitary Sewer Service
Com pliance Irispecti •In
Date
•
Name
Number
House Number
Transition
Alternative Mailing Address
4" to 6" Transition:
Street Name
Owner/Occupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
White Copy: Property Owner
Time .l • Pm
Disk #
7 EE"
Phone
1
Record Number
[
/ f' •
JJJjJJ JJJJJJ
Inspector Signature
3 0 am
CJ Pm
Li
For information call 651.470.2788
Compliance Non - Compliance Obstruction No Access
No foundation drain connection 0 Clear water connections to Unable to push past 0 No one in
sanitary sewer feet.
O Access to service.
No roof drain connection
0 Service lateral defects lateral needed
O Sump pit not connected to " 0 Defective manholes
sanitary sewer
• Inspection
Sump pump connected to sanitary refused
O Sump pump properly piped sewer
O No sump pump r Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Entered S.L at :� ` " �
Roots ' -- 2.
- • J-
Poor Pipe Joints Tf /. w ▪ ' ""?..-==-1--4"--
Length of Service:
otes
I Final Cleanout:
^`Y
.1// ' - e!/V ' a ' '
> i i f / /
�,t 1 f. ,.. ', `- fir 1 �''%' =- . t.
-- ,i(L V — 4 , 1 6 6 a I ,i,,,,,,,_-_--,
: i .- 1
,..-,7--„._,,,,,, _,
r- /- - --, ,._z6)-7,---.3,:.:-.-:„ / ,,,,,,e-,
„.,..,.,....„ ,. ,c
f
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Correctly
. Discharged
Incorrectly
Unknown
Total
Sump pumps
Foundation drains
Roof drains
Residential Sanitary Sewer Service
Com pliance Irispecti •In
Date
•
Name
Number
House Number
Transition
Alternative Mailing Address
4" to 6" Transition:
Street Name
Owner/Occupant Signature
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
White Copy: Property Owner
Time .l • Pm
Disk #
7 EE"
Phone
1
Record Number
[
/ f' •
JJJjJJ JJJJJJ
Inspector Signature
3 0 am
CJ Pm
Li
For information call 651.470.2788
Compliance Non - Compliance Obstruction No Access
No foundation drain connection 0 Clear water connections to Unable to push past 0 No one in
sanitary sewer feet.
O Access to service.
No roof drain connection
0 Service lateral defects lateral needed
O Sump pit not connected to " 0 Defective manholes
sanitary sewer
• Inspection
Sump pump connected to sanitary refused
O Sump pump properly piped sewer
O No sump pump r Flexible sump pump piping
Service Lateral Inspection Findings Number of stacks
Entered S.L at :� ` " �
Roots ' -- 2.
- • J-
Poor Pipe Joints Tf /. w ▪ ' ""?..-==-1--4"--
Length of Service:
otes
I Final Cleanout:
^`Y
.1// ' - e!/V ' a ' '
> i i f / /
�,t 1 f. ,.. ', `- fir 1 �''%' =- . t.
-- ,i(L V — 4 , 1 6 6 a I ,i,,,,,,,_-_--,
: i .- 1
,..-,7--„._,,,,,, _,
r- /- - --, ,._z6)-7,---.3,:.:-.-:„ / ,,,,,,e-,
„.,..,.,....„ ,. ,c
f
Yellow Copy: City of Eagan Pink Copy: SEH